POTTAWATTAMIE COUNTY NPI 1053881102

NPI Information

NPI: 1053881102
Provider Name: POTTAWATTAMIE COUNTY
Classification: Public Health or Welfare - 251K00000X
Entity Type: Organization

CLIA Number: 16D0983169

Address:
600 S 4TH ST
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (712) 328-5792
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POTTAWATTAMIE COUNTY is a public health or welfare in Council Bluffs, IA. POTTAWATTAMIE COUNTY NPI is 1053881102. The provider is registered as an organization entity type.

The provider's business location address is:

600 S 4TH ST
COUNCIL BLUFFS, IA
ZIP 51503-535
Phone: (712) 328-5792
Fax: (712) 328-4731

The provider's authorized official is Maria Sieck .
The authorized official title is Office Manager and has the following contact phone number (712) 242-1155.

The CLIA number assigned to this NPI record is 16D0983169 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/3/2018 and was last updated on 6/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251K00000X	Public Health or Welfare				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0082503	MEDICAID	IOWA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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