Organization
CITY OF SUTHERLAND
Active
Other names
Sutherland Amulance
Organization subpart
No
Provider details
NPI number
Authorized official
JOSH J MOERMOND (DIRECTOR)
(712) 446-2628
Entity
Organization
Contact information
Practice address
116 PINE ST, SUTHERLAND, IA 51058
(712) 446-2242
Mailing address
409 ASH ST, PO BOX 128, SUTHERLAND, IA 51058-7663
(712) 446-2243
Taxonomy
Speciality
Code
Description
License number
State
261QE0002X
Emergency Care Clinic/Center
Primary
2710600
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0068163
—
IA
01
—
06816
BLUE CROSS BLUE SHIELD
IA
Enumeration date
11/20/2006
Last updated
06/19/2008
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