Provider Demographics
NPI:1295701126
Name:COUNTY OF MADISON
Entity type:Organization
Organization Name:COUNTY OF MADISON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD OF HEALTH CHAIRMAN
Authorized Official - Prefix:MR
Authorized Official - First Name:MARVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FIRCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-281-4808
Mailing Address - Street 1:1008 N JOHN WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:WINTERSET
Mailing Address - State:IA
Mailing Address - Zip Code:50273-1233
Mailing Address - Country:US
Mailing Address - Phone:515-462-9051
Mailing Address - Fax:515-462-9061
Practice Address - Street 1:1008 N JOHN WAYNE DR
Practice Address - Street 2:
Practice Address - City:WINTERSET
Practice Address - State:IA
Practice Address - Zip Code:50273-1233
Practice Address - Country:US
Practice Address - Phone:515-462-9051
Practice Address - Fax:515-462-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-28
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
IAN/A251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0433888Medicaid