| |
105 E Main St Waukon IA 52172-1735 | |
(563) 568-3411 | |
(563) 568-5699 |
Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 105 E Main St, Waukon, Iowa |
Authorized Official Name and Position | Michael F Coyle (CEO) |
Authorized Official Contact | 5635683411 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
40 1st St Se Waukon IA 52172-2022 Ph: (563) 568-3411 | 105 E Main St Waukon IA 52172-1735 Ph: (563) 568-3411 |
NPI Number | 1093306425 |
---|---|
Provider Enumeration Date | 01/28/2021 |
Last Update Date | 07/27/2023 |
Medicare PECOS PAC ID | 1355230293 |
---|---|
Medicare Enrollment ID | O20210316000936 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093306425 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |