Provider Demographics
NPI:1235758681
Name:JOHNSON COUNTY PUBLIC HEALTH
Entity Type:Organization
Organization Name:JOHNSON COUNTY PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SERVICES DATA SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:ACKERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LBSW
Authorized Official - Phone:319-688-5891
Mailing Address - Street 1:855 S DUBUQUE ST STE 217
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4297
Mailing Address - Country:US
Mailing Address - Phone:319-688-5891
Mailing Address - Fax:
Practice Address - Street 1:855 S DUBUQUE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4281
Practice Address - Country:US
Practice Address - Phone:319-356-6042
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF JOHNSON
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-04-15
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical