Provider Demographics
NPI:1043698160
Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Entity Type:Organization
Organization Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Other - Org Name:PAIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:BREVIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-547-6677
Mailing Address - Street 1:235 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1062
Mailing Address - Country:US
Mailing Address - Phone:563-547-2101
Mailing Address - Fax:563-547-3448
Practice Address - Street 1:235 8TH AVE W
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1062
Practice Address - Country:US
Practice Address - Phone:563-547-2101
Practice Address - Fax:563-547-3448
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA450057H367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty