Provider Demographics
NPI:1851429344
Name:ADLM COUNTIES ENVIRONMENTAL PUBLIC HEALTH
Entity Type:Organization
Organization Name:ADLM COUNTIES ENVIRONMENTAL PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CONNIE
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-724-3511
Mailing Address - Street 1:12307 HIGHWAY 5
Mailing Address - Street 2:P.O. BOX 399
Mailing Address - City:MORAVIA
Mailing Address - State:IA
Mailing Address - Zip Code:52571-8977
Mailing Address - Country:US
Mailing Address - Phone:641-724-3511
Mailing Address - Fax:641-724-3513
Practice Address - Street 1:12307 HIGHWAY 5
Practice Address - Street 2:
Practice Address - City:MORAVIA
Practice Address - State:IA
Practice Address - Zip Code:52571-8977
Practice Address - Country:US
Practice Address - Phone:641-724-3511
Practice Address - Fax:641-724-3513
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA2003FIRM0127251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0177535OtherPIN#