Provider Demographics
NPI:1912226226
Name:COUNTY OF BREMER
Entity Type:Organization
Organization Name:COUNTY OF BREMER
Other - Org Name:BREMER COUNTY HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDLEY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:SHARP
Authorized Official - Suffix:
Authorized Official - Credentials:MPH
Authorized Official - Phone:319-352-0082
Mailing Address - Street 1:403 3RD ST SE
Mailing Address - Street 2:
Mailing Address - City:WAVERLY
Mailing Address - State:IA
Mailing Address - Zip Code:50677-3513
Mailing Address - Country:US
Mailing Address - Phone:319-352-0082
Mailing Address - Fax:319-352-5092
Practice Address - Street 1:403 3RD ST SE
Practice Address - Street 2:
Practice Address - City:WAVERLY
Practice Address - State:IA
Practice Address - Zip Code:50677-3513
Practice Address - Country:US
Practice Address - Phone:319-352-2990
Practice Address - Fax:319-352-2979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-26
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA001553Medicaid