Provider Demographics
NPI:1982210167
Name:COUNTY OF SAC
Entity Type:Organization
Organization Name:COUNTY OF SAC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:DUFFY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:712-662-4785
Mailing Address - Street 1:116 S STATE ST STE A
Mailing Address - Street 2:
Mailing Address - City:SAC CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50583-2350
Mailing Address - Country:US
Mailing Address - Phone:712-662-4785
Mailing Address - Fax:712-662-7862
Practice Address - Street 1:116 S STATE ST STE A
Practice Address - Street 2:
Practice Address - City:SAC CITY
Practice Address - State:IA
Practice Address - Zip Code:50583-2350
Practice Address - Country:US
Practice Address - Phone:712-662-4785
Practice Address - Fax:712-662-7862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare