| |
803 S Greene St Rock Rapids IA 51246-1948 | |
(712) 472-3716 | |
(712) 472-2878 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 803 S Greene St, Rock Rapids, Iowa |
Authorized Official Name and Position | Joel Mason Gustafson (ADMINISTRATOR) |
Authorized Official Contact | 7124723716 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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803 S Greene St Rock Rapids IA 51246-1948 Ph: (712) 472-3716 | 803 S Greene St Rock Rapids IA 51246-1948 Ph: (712) 472-3716 |
NPI Number | 1245300557 |
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Provider Enumeration Date | 11/08/2006 |
Last Update Date | 11/27/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245300557 | NPI | - | NPPES |
0250498 | Medicaid | IA | |
0638700 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |