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109 Broad St Humeston IA 50123-7736 | |
(641) 877-6108 | |
(641) 877-6123 |
Full Name | |
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Speciality | Clinic/Center |
Location | 109 Broad St, Humeston, Iowa |
Authorized Official Name and Position | Daren L Relph (CEO) |
Authorized Official Contact | 6418722260 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 305 Corydon IA 50060-0305 Ph: (641) 872-5341 | 109 Broad St Humeston IA 50123-7736 Ph: (641) 877-6108 |
NPI Number | 1275825838 |
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Provider Enumeration Date | 05/13/2011 |
Last Update Date | 12/06/2012 |
Medicare PECOS PAC ID | 4082508734 |
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Medicare Enrollment ID | O20120328000101 |
Identifier | Type | State | Issuer |
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1275825838 | NPI | - | NPPES |