Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 118 S 1st Ave, Logan, Iowa |
Authorized Official Name and Position | Evert Kuiper (CEO - CHI HEALTH) |
Authorized Official Contact | 4023434420 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
118 S 1st Ave Logan IA 51546-1306 Ph: (712) 644-3288 | 118 S 1st Ave Logan IA 51546-1306 Ph: (712) 644-3288 |
NPI Number | 1558442269 |
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Provider Enumeration Date | 10/18/2006 |
Last Update Date | 02/10/2022 |
Medicare PECOS PAC ID | 3678482130 |
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Medicare Enrollment ID | O20070530000296 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558442269 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |