Provider Demographics
NPI:1649267113
Name:COUNTY OF WARREN
Entity type:Organization
Organization Name:COUNTY OF WARREN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH DIRECTOR/ADMINISTRATO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:STOLTE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MPH
Authorized Official - Phone:515-690-9190
Mailing Address - Street 1:301 NORTH BUXTON STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:INDIANOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50125-1801
Mailing Address - Country:US
Mailing Address - Phone:515-690-9190
Mailing Address - Fax:515-690-9209
Practice Address - Street 1:301 NORTH BUXTON STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:INDIANOLA
Practice Address - State:IA
Practice Address - Zip Code:50125-1801
Practice Address - Country:US
Practice Address - Phone:515-690-9190
Practice Address - Fax:515-690-9209
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COUNTY OF WARREN
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-09-30
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA251K00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670331Medicaid
IA0670331Medicaid