Full Name | |
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Speciality | Clinic/Center |
Location | 319 E Main St, Panora, Iowa |
Authorized Official Name and Position | Debbie Miner (CFO) |
Authorized Official Contact | 5154657653 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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610 10th St Perry IA 50220-2249 Ph: (515) 465-3547 | 319 E Main St Panora IA 50216-1064 Ph: (641) 755-2121 |
NPI Number | 1023676400 |
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Provider Enumeration Date | 05/31/2019 |
Last Update Date | 08/03/2020 |
Medicare PECOS PAC ID | 9931094257 |
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Medicare Enrollment ID | O20190910001028 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023676400 | NPI | - | NPPES |