Provider Demographics
NPI:1386720563
Name:COUNTY OF VAN BUREN
Entity type:Organization
Organization Name:COUNTY OF VAN BUREN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDEE
Authorized Official - Middle Name:J
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:319-293-3431
Mailing Address - Street 1:PO BOX 514
Mailing Address - Street 2:905 BROAD ST
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-0514
Mailing Address - Country:US
Mailing Address - Phone:319-293-3431
Mailing Address - Fax:319-293-3609
Practice Address - Street 1:905 BROAD ST COURTHOUSE
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-0514
Practice Address - Country:US
Practice Address - Phone:319-293-3431
Practice Address - Fax:319-293-3609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2010-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67111OtherBCBS OF IA
IA0671115Medicaid
IA67111OtherBCBS OF IA