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110 Jefferson St West Union IA 52175-1022 | |
(563) 422-3810 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 110 Jefferson St, West Union, Iowa |
Authorized Official Name and Position | Patrice Kuennen (CEO) |
Authorized Official Contact | 5634223811 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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110 Jefferson St West Union IA 52175-1022 Ph: (563) 422-3810 | 110 Jefferson St West Union IA 52175-1022 Ph: (563) 422-3810 |
NPI Number | 1639533763 |
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Provider Enumeration Date | 04/05/2016 |
Last Update Date | 11/29/2018 |
Medicare PECOS PAC ID | 4284544255 |
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Medicare Enrollment ID | O20160811000117 |
Identifier | Type | State | Issuer |
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1639533763 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |