Provider Demographics
NPI:1528124831
Name:TOWN OF STRAWBERRY POINT
Entity type:Organization
Organization Name:TOWN OF STRAWBERRY POINT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CITY ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:DEMENT
Authorized Official - Suffix:
Authorized Official - Credentials:CITY ADMINISTRATOR
Authorized Official - Phone:563-933-4482
Mailing Address - Street 1:PO BOX 279
Mailing Address - Street 2:
Mailing Address - City:STRAWBERRY POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52076-0279
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:STRAWBERRY POINT
Practice Address - State:IA
Practice Address - Zip Code:52076
Practice Address - Country:US
Practice Address - Phone:515-887-3553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2008-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA22205003416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0011700Medicaid
IA01170Medicare PIN