Organization
COUNTY OF VAN BUREN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDEE J THOMAS RN (NURSE ADMINISTRATOR)
(319) 293-3431
Entity
Organization
Contact information
Practice address
905 BROAD ST COURTHOUSE, KEOSAUQUA, IA 52565-0514
(319) 293-3431
(319) 293-3609
Mailing address
PO BOX 514, 905 BROAD ST, KEOSAUQUA, IA 52565-0514
(319) 293-3431
(319) 293-3609
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0671115
—
IA
01
—
67111
BCBS OF IA
IA
Enumeration date
10/31/2006
Last updated
02/22/2010
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