Provider Demographics
NPI:1295818524
Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Entity Type:Organization
Organization Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Other - Org Name:LIME SPRINGS MEDICAL 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 1:101 W MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:LIME SPRINGS
Mailing Address - State:IA
Mailing Address - Zip Code:52155
Mailing Address - Country:US
Mailing Address - Phone:563-566-2243
Mailing Address - Fax:
Practice Address - Street 1:101 W MAIN STREET
Practice Address - Street 2:
Practice Address - City:LIME SPRINGS
Practice Address - State:IA
Practice Address - Zip Code:52155
Practice Address - Country:US
Practice Address - Phone:563-566-2243
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA450057H261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0635029Medicaid
IA48235OtherBLUE CROSS/RURAL HEALTH
IA163494Medicare Oscar/Certification