Provider Demographics
NPI:1457825192
Name:GREENE COUNTY MEDICAL CENTER
Entity Type:Organization
Organization Name:GREENE COUNTY MEDICAL CENTER
Other - Org Name:GREENE COUNTY FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:H
Authorized Official - Last Name:BUTTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-386-2114
Mailing Address - Street 1:1000 W LINCOLN WAY
Mailing Address - Street 2:
Mailing Address - City:JEFFERSON
Mailing Address - State:IA
Mailing Address - Zip Code:50129-1645
Mailing Address - Country:US
Mailing Address - Phone:515-386-2114
Mailing Address - Fax:515-386-3695
Practice Address - Street 1:1000 W LINCOLN WAY STE 100 & 101
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:IA
Practice Address - Zip Code:50129-1645
Practice Address - Country:US
Practice Address - Phone:515-386-2114
Practice Address - Fax:515-386-3695
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GREENE COUNTY MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-16
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health