Provider Demographics
NPI:1184094534
Name:WAVERLY HEALTH CENTER
Entity type:Organization
Organization Name:WAVERLY HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:JODI
Authorized Official - Middle Name:M
Authorized Official - Last Name:GEERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-352-4120
Mailing Address - Street 1:312 9TH ST SW
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-2929
Mailing Address - Country:US
Mailing Address - Phone:319-352-4120
Mailing Address - Fax:319-352-3992
Practice Address - Street 1:202 WILDCAT WAY
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:IA
Practice Address - Zip Code:50647-1016
Practice Address - Country:US
Practice Address - Phone:319-987-2361
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAVERLY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-09-29
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health