Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 520 Main St, Mapleton, Iowa |
Authorized Official Name and Position | Joni G Schumann (CFO) |
Authorized Official Contact | 7123643311 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
701 E 2nd St Ida Grove IA 51445-1699 Ph: (712) 364-3311 | 520 Main St Mapleton IA 51034-1215 Ph: (712) 881-4676 |
NPI Number | 1003157603 |
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Provider Enumeration Date | 03/06/2013 |
Last Update Date | 03/16/2021 |
Medicare PECOS PAC ID | 9537070826 |
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Medicare Enrollment ID | O20130513000134 |
Identifier | Type | State | Issuer |
---|---|---|---|
1003157603 | NPI | - | NPPES |
168558 | Other | IA | MEDICARE PTAN |
705750 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |