Provider Demographics
NPI:1306935101
Name:TOWN OF BROOKLYN
Entity type:Organization
Organization Name:TOWN OF BROOKLYN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCONNELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-522-7371
Mailing Address - Street 1:PO BOX 269
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:IA
Mailing Address - Zip Code:52211-0269
Mailing Address - Country:US
Mailing Address - Phone:641-522-7371
Mailing Address - Fax:641-522-7400
Practice Address - Street 1:134 JACKSON
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:IA
Practice Address - Zip Code:52211-0269
Practice Address - Country:US
Practice Address - Phone:641-522-7371
Practice Address - Fax:641-522-7400
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWN OF BROOKLYN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-12
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA27906003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0123018Medicaid
IA12301Medicare PIN