Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 709 2nd St, Victor, Iowa |
Authorized Official Name and Position | Barry G Goettsch (CEO) |
Authorized Official Contact | 3196425543 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
300 W May St Marengo IA 52301-1261 Ph: (319) 642-8160 | 709 2nd St Victor IA 52347-7709 Ph: (319) 647-7511 |
NPI Number | 1679246722 |
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Provider Enumeration Date | 07/26/2021 |
Last Update Date | 07/28/2021 |
Medicare PECOS PAC ID | 0749199446 |
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Medicare Enrollment ID | O20210809002014 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679246722 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |