| Country Clinic Medical Services Inc | |
|
120 Ne Dartmoor Dr Waukee IA 50263-9660 | |
| (515) 987-3117 | |
| (515) 987-3119 |
| Full Name | Country Clinic Medical Services Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 120 Ne Dartmoor Dr, Waukee, Iowa |
| Authorized Official Name and Position | Kim K Countryman (OWNER) |
| Authorized Official Contact | 5159873117 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Country Clinic Medical Services Inc 120 Ne Dartmoor Dr Po Box 968 Waukee IA 50263-9660 Ph: (515) 987-3117 | Country Clinic Medical Services Inc 120 Ne Dartmoor Dr Waukee IA 50263-9660 Ph: (515) 987-3117 |
| NPI Number | 1396890158 |
|---|---|
| Provider Enumeration Date | 01/24/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396890158 | NPI | - | NPPES |
| 0284083 | Medicaid | IA | |
| 1043646 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02312 (Iowa) | Primary |
Serenity Care And Life Skills Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Ne Horizon Dr Apt 108, Waukee, IA 50263 Phone: 515-745-5069 |