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14983 275 Street Cantril IA 52542-8087 | |
(319) 397-2300 | |
(319) 293-2300 |
Full Name | |
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Speciality | Clinic/Center |
Location | 14983 275 Street, Cantril, Iowa |
Authorized Official Name and Position | Kara M. Mcentee (CFO) |
Authorized Official Contact | 3192933171 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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304 Franklin St Keosauqua IA 52565-1164 Ph: (319) 293-3171 | 14983 275 Street Cantril IA 52542-8087 Ph: (319) 397-2300 |
NPI Number | 1578641593 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 10/11/2014 |
Medicare PECOS PAC ID | 7214829530 |
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Medicare Enrollment ID | O20100308000640 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578641593 | NPI | - | NPPES |
0639963 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |