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?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare