Provider Demographics
NPI:1235218819
Name:PLANNED PARENTHOOD OF THE HEARTLAND
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF THE HEARTLAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-698-2406
Mailing Address - Street 1:671 VANDALIA ST
Mailing Address - Street 2:ATTN: PPH
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1312
Mailing Address - Country:US
Mailing Address - Phone:866-290-4325
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:1604 2ND AVENUE
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3801
Practice Address - Country:US
Practice Address - Phone:712-332-7985
Practice Address - Fax:712-322-7985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF-091658261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0131656Medicaid
IA0131656Medicaid
276286Medicare ID - Type Unspecified