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208 Main St Lake View IA 51450-7717 | |
(712) 657-8513 | |
(712) 657-2939 |
Full Name | |
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Speciality | Clinic/Center |
Location | 208 Main St, Lake View, Iowa |
Authorized Official Name and Position | Leah M Glasgo (MARKET PRESIDENT) |
Authorized Official Contact | 5155733101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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802 Kenyon Rd Fort Dodge IA 50501-5740 Ph: (515) 574-6565 | 208 Main St Lake View IA 51450-7717 Ph: (712) 657-8513 |
NPI Number | 1841718582 |
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Provider Enumeration Date | 09/01/2017 |
Last Update Date | 11/19/2024 |
Medicare PECOS PAC ID | 7315858529 |
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Medicare Enrollment ID | O20171128003504 |
Identifier | Type | State | Issuer |
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1841718582 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |