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109 Westward Dr # 6 Riceville IA 50466-7550 | |
(641) 985-2122 | |
(641) 985-2839 |
Full Name | |
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Speciality | Clinic/Center |
Location | 109 Westward Dr # 6, Riceville, Iowa |
Authorized Official Name and Position | Michele Russell (CEO) |
Authorized Official Contact | 6417326003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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616 N 8th St Osage IA 50461-1456 Ph: (641) 732-6000 | 109 Westward Dr # 6 Riceville IA 50466-7550 Ph: (641) 985-2122 |
NPI Number | 1689766206 |
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Provider Enumeration Date | 09/29/2006 |
Last Update Date | 12/07/2020 |
Medicare PECOS PAC ID | 5890603070 |
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Medicare Enrollment ID | O20030604000005 |
Identifier | Type | State | Issuer |
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1689766206 | NPI | - | NPPES |
0635037 | Medicaid | IA |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |