Provider Demographics
NPI:1528186640
Name:PAGE COUNTY
Entity Type:Organization
Organization Name:PAGE COUNTY
Other - Org Name:PAGE COUNTY PUBLIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DEBOLT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-246-2332
Mailing Address - Street 1:1208 W NISHNA RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-2116
Mailing Address - Country:US
Mailing Address - Phone:712-246-2332
Mailing Address - Fax:712-246-2552
Practice Address - Street 1:1208 W NISHNA RD
Practice Address - Street 2:SUITE B
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-2116
Practice Address - Country:US
Practice Address - Phone:712-246-2332
Practice Address - Fax:712-246-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2008-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0287979Medicaid