Provider Demographics
NPI:1588492862
Name:KEOKUK COUNTY HEALTH CENTER
Entity type:Organization
Organization Name:KEOKUK COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:J
Authorized Official - Last Name:IVES
Authorized Official - Suffix:
Authorized Official - Credentials:CEO/CFO
Authorized Official - Phone:641-622-1155
Mailing Address - Street 1:23019 HIGHWAY 149
Mailing Address - Street 2:
Mailing Address - City:SIGOURNEY
Mailing Address - State:IA
Mailing Address - Zip Code:52591-1194
Mailing Address - Country:US
Mailing Address - Phone:641-622-1148
Mailing Address - Fax:641-210-4593
Practice Address - Street 1:115 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HEDRICK
Practice Address - State:IA
Practice Address - Zip Code:52563
Practice Address - Country:US
Practice Address - Phone:641-653-2437
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEOKUK COUNTY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care