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111 S Main St Kingsley IA 51028-5021 | |
(712) 378-2921 | |
(712) 378-2965 |
Full Name | |
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Speciality | Clinic/Center |
Location | 111 S Main St, Kingsley, Iowa |
Authorized Official Name and Position | Jesica Hanson (VP FINANCE) |
Authorized Official Contact | 7122795850 |
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 328 Sioux City IA 51102-0328 Ph: (712) 279-5830 | 111 S Main St Kingsley IA 51028-5021 Ph: (712) 378-2921 |
NPI Number | 1790723633 |
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Provider Enumeration Date | 06/03/2006 |
Last Update Date | 10/18/2024 |
Medicare PECOS PAC ID | 5799694063 |
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Medicare Enrollment ID | O20030310000014 |
Identifier | Type | State | Issuer |
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1790723633 | NPI | - | NPPES |
0638676 | Medicaid | IA |