| Waiver | |
|
2301 Eastern Ave, Red Oak, IA 51566-0498 | |
| (712) 623-7156 | |
| (712) 623-7224 |
| Full Name | Waiver |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 2301 Eastern Ave, Red Oak, Iowa |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558496620 | NPI | - | NPPES |
| 0164715 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 690075H (Iowa) | Primary |
| 332U00000X | Home Delivered Meals | 690075H (Iowa) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Waiver Po Box 498, Red Oak, IA 51566-0498 Ph: (712) 623-7156 | Waiver 2301 Eastern Ave, Red Oak, IA 51566-0498 Ph: (712) 623-7156 |
Emily Kaye Furst, MS, RD, LD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2301 Eastern Ave, Red Oak, IA 51566 Phone: 712-623-7166 |
Erin Mcnamara, M.S., R.D., L.D. Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2301 Eastern Ave, Red Oak, IA 51566 Phone: 712-623-7286 |
Montgomery County Memorial Hospital Dietitian Medicare: Medicare Enrolled Practice Location: 2301 Eastern Ave, Red Oak, IA 51566 Phone: 712-623-7000 Fax: 712-623-7224 |
Brenda Kay Shannon, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 2301 Eastern Ave, Red Oak, IA 51566 Phone: 712-623-7166 Fax: 712-623-8442 |
Kimberly Lynn Bond, RD, LMNT, LD, CNSC Dietitian Medicare: Not Enrolled in Medicare Practice Location: 1969 Evergreen Ave, Red Oak, IA 51566 Phone: 712-326-5722 |