Provider Demographics
NPI:1972583888
Name:COUNTY OF DES MOINES
Entity type:Organization
Organization Name:COUNTY OF DES MOINES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-753-8215
Mailing Address - Street 1:522 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52601-5226
Mailing Address - Country:US
Mailing Address - Phone:319-753-8290
Mailing Address - Fax:319-753-8703
Practice Address - Street 1:522 N 3RD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52601-5226
Practice Address - Country:US
Practice Address - Phone:319-753-8290
Practice Address - Fax:319-753-8703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251E00000X251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67026OtherBLUE CROSS BLUE SHIELD
IA0181602Medicaid
IA0069054Medicaid
IA0670265Medicaid
IA0089821Medicaid
IA0069054Medicaid