Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 92 Main St, Massena, Iowa |
Authorized Official Name and Position | Abbey L Stangl (CFO) |
Authorized Official Contact | 7122437804 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
1501 E 10th St Atlantic IA 50022-1936 Ph: (712) 243-2850 | 92 Main St Massena IA 50853-1016 Ph: (712) 779-3626 |
NPI Number | 1447451331 |
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Provider Enumeration Date | 05/30/2007 |
Last Update Date | 01/16/2023 |
Medicare PECOS PAC ID | 5294634994 |
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Medicare Enrollment ID | O20070605000520 |
Identifier | Type | State | Issuer |
---|---|---|---|
1447451331 | NPI | - | NPPES |
1447451331 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |