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503 3rd Ave Sw State Center IA 50247-7719 | |
(641) 844-2970 | |
Not Available |
Full Name | |
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Speciality | Clinic/Center |
Location | 503 3rd Ave Sw, State Center, Iowa |
Authorized Official Name and Position | Pamela K. Delagardelle (CEO) |
Authorized Official Contact | 3192353606 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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55 Unitypoint Way Marshalltown IA 50158-4749 Ph: (641) 754-5145 | 503 3rd Ave Sw State Center IA 50247-7719 Ph: (641) 844-2970 |
NPI Number | 1407381031 |
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Provider Enumeration Date | 04/20/2017 |
Last Update Date | 04/27/2022 |
Medicare PECOS PAC ID | 0941587307 |
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Medicare Enrollment ID | O20170512000313 |
Identifier | Type | State | Issuer |
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1407381031 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |