Provider Demographics
NPI:1275995045
Name:JASPER COUNTY HEALTH DEPARTMENT
Entity Type:Organization
Organization Name:JASPER COUNTY HEALTH DEPARTMENT
Other - Org Name:JASPER COUNTY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINSTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:641-787-9224
Mailing Address - Street 1:115 N 2ND AVENUE E
Mailing Address - Street 2:COUNTY ANNEX BUILDING B-1
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208
Mailing Address - Country:US
Mailing Address - Phone:641-787-9224
Mailing Address - Fax:641-792-5700
Practice Address - Street 1:115 N 2ND AVENUE E
Practice Address - Street 2:COUNTY ANNEX BUILDING B-1
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208
Practice Address - Country:US
Practice Address - Phone:641-787-9224
Practice Address - Fax:641-792-5700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0211672Medicaid