Provider Demographics
NPI:1851341952
Name:COUNTY OF IOWA
Entity type:Organization
Organization Name:COUNTY OF IOWA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RN, BSN
Authorized Official - Prefix:
Authorized Official - First Name:JUNE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:MEUDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-930-9870
Mailing Address - Street 1:303 W CHAPEL ST STE 2200
Mailing Address - Street 2:
Mailing Address - City:DODGEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53533-1314
Mailing Address - Country:US
Mailing Address - Phone:608-930-9870
Mailing Address - Fax:608-937-0501
Practice Address - Street 1:303 W CHAPEL ST STE 2200
Practice Address - Street 2:
Practice Address - City:DODGEVILLE
Practice Address - State:WI
Practice Address - Zip Code:53533-1314
Practice Address - Country:US
Practice Address - Phone:608-930-9870
Practice Address - Fax:608-937-0501
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF IOWA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-11
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI44009100Medicaid
WI41862900Medicaid
WI43080800Medicaid
WI44009100Medicaid