Provider Demographics
NPI: | 1093132342 |
---|---|
Name: | WOODBURY COUNTY GOVERNMENT |
Entity Type: | Organization |
Organization Name: | WOODBURY COUNTY GOVERNMENT |
Other - Org Name: | SIOUXLAND DISTRICT HEALTH DEPARTMENT |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | HEALTH DIRECTOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | KEVIN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | GRIEME |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MS, BS |
Authorized Official - Phone: | 712-279-6119 |
Mailing Address - Street 1: | 1014 NEBRASKA ST |
Mailing Address - Street 2: | |
Mailing Address - City: | SIOUX CITY |
Mailing Address - State: | IA |
Mailing Address - Zip Code: | 51105-1435 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 712-279-6119 |
Mailing Address - Fax: | 712-255-2605 |
Practice Address - Street 1: | 1014 NEBRASKA ST |
Practice Address - Street 2: | |
Practice Address - City: | SIOUX CITY |
Practice Address - State: | IA |
Practice Address - Zip Code: | 51105-1435 |
Practice Address - Country: | US |
Practice Address - Phone: | 712-279-6119 |
Practice Address - Fax: | 712-255-2605 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | WOODBURY COUNTY GOVERNMENT |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2014-03-25 |
Last Update Date: | 2014-03-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251K00000X | Agencies | Public Health or Welfare |