| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1803 C Ave, Vinton, Iowa |
| Authorized Official Name and Position | Erick J Laine (COO) |
| Authorized Official Contact | 5154719227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8101 Birchwood Court Suite R Johnston IA 50131-2930 Ph: (515) 471-9243 | 1803 C Ave Vinton IA 52349-1691 Ph: (319) 472-2304 |
| NPI Number | 1649215005 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 08/15/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649215005 | NPI | - | NPPES |
| 0638965 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Benton County Public Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 811 D Ave Ste 29, Vinton, IA 52349 Phone: 319-214-2601 Fax: 319-214-6102 |