Provider Demographics
NPI:1295782217
Name:COUNTY OF AUDUBON
Entity type:Organization
Organization Name:COUNTY OF AUDUBON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:NURSE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-563-2226
Mailing Address - Street 1:318 LEROY ST
Mailing Address - Street 2:
Mailing Address - City:AUDUBON
Mailing Address - State:IA
Mailing Address - Zip Code:50025-1255
Mailing Address - Country:US
Mailing Address - Phone:712-563-2226
Mailing Address - Fax:712-563-2072
Practice Address - Street 1:318 LEROY ST
Practice Address - Street 2:
Practice Address - City:AUDUBON
Practice Address - State:IA
Practice Address - Zip Code:50025-1255
Practice Address - Country:US
Practice Address - Phone:712-563-2226
Practice Address - Fax:712-563-2072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670836Medicaid
IA167083Medicare ID - Type Unspecified