| |
301 Highland Ave Sac City IA 50583-2411 | |
(712) 662-7119 | |
(712) 662-7728 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 301 Highland Ave, Sac City, 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 |
---|---|
802 Kenyon Rd Fort Dodge IA 50501-5740 Ph: (515) 574-6565 | 301 Highland Ave Sac City IA 50583-2411 Ph: (712) 662-7119 |
NPI Number | 1861910507 |
---|---|
Provider Enumeration Date | 09/01/2017 |
Last Update Date | 11/19/2024 |
Medicare PECOS PAC ID | 7315858529 |
---|---|
Medicare Enrollment ID | O20171128002296 |
Identifier | Type | State | Issuer |
---|---|---|---|
1861910507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |