Provider Demographics
NPI:1750701439
Name:COUNTY OF JOHNSON
Entity type:Organization
Organization Name:COUNTY OF JOHNSON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BEARDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-688-5859
Mailing Address - Street 1:855 S DUBUQUE ST
Mailing Address - Street 2:SUITE 217
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4281
Mailing Address - Country:US
Mailing Address - Phone:319-356-6040
Mailing Address - Fax:319-339-6176
Practice Address - Street 1:855 S DUBUQUE
Practice Address - Street 2:SUITE 217
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-356-6040
Practice Address - Fax:319-339-6176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-22
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare