Provider Demographics
NPI:1710187497
Name:IOWA CENTRAL COMMUNITY COLLEGE
Entity Type:Organization
Organization Name:IOWA CENTRAL COMMUNITY COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:
Authorized Official - Last Name:PIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-574-1335
Mailing Address - Street 1:330 AVENUE M
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-5739
Mailing Address - Country:US
Mailing Address - Phone:515-574-1327
Mailing Address - Fax:515-576-5656
Practice Address - Street 1:330 AVENUE M
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-5739
Practice Address - Country:US
Practice Address - Phone:515-574-1327
Practice Address - Fax:515-576-5656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental