Stormwater- Affiliates

Facility Name: SHENANDOAH DISEASE CONTROL & WELLNESS CENTER

Permit Type: GP #2 Legal Status: Private     File No: 6969   Authorization No: 6969-6775

Expiration Date: 10/27/2004 (discontinued) Address: 300 PERSHING AVENUE - SHENANDOAH , IA 51601

County: PAGE Field Office: 4 SIC: Geospatial Information: 300110(X)/4514073(Y)

Affiliates   Name Address City State Zip Phone Type SHENANDOAH MEDICAL CENTER 300 PERSHING AVENUE SHENANDOAH IA 51601 (712)246-1230 Contact SHENANDOAH MEDICAL CENTER 300 PERSHING AVENUE SHENANDOAH IA 51601 (712)246-1230 Owner RANDY ROGGE SOUTH 58TH STREET, SUITE A LINCOLN NE 68516 (402)441-3100 Contact Individual? Type:* --AFFILIATE TYPE-- OWNER OPERATOR CONTACT CERTIFIER Name: Title:   Company Name: C/O:   Address: Address 2: City/State/Zip   --Select-- AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA DC WV WI WY PR OT E-mail:   Contact Owner   NO YES Preferred Method of contact EMAIL US MAIL Business Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Ext: Home Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Fax:   Error! Phone Number Format Must Be (XXX)XXX-XXXX Mobile Phone:   Error! Phone Number Format Must Be (XXX)XXX-XXXX