Provider Demographics
NPI:1780654855
Name:COUNTY OF GUTHRIE
Entity Type:Organization
Organization Name:COUNTY OF GUTHRIE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOTHAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:ARBER
Authorized Official - Suffix:
Authorized Official - Credentials:BA, MPH
Authorized Official - Phone:641-747-3972
Mailing Address - Street 1:2002 STATE ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:GUTHRIE CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50115-8897
Mailing Address - Country:US
Mailing Address - Phone:641-747-3972
Mailing Address - Fax:641-747-3839
Practice Address - Street 1:2002 STATE ST
Practice Address - Street 2:SUITE 1
Practice Address - City:GUTHRIE CENTER
Practice Address - State:IA
Practice Address - Zip Code:50115-8897
Practice Address - Country:US
Practice Address - Phone:641-747-3972
Practice Address - Fax:641-747-3839
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-23
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0671081Medicaid
IA0671081Medicaid