| Medical Clinic Llc | |
|
710 Center St Tabor IA 51653-2069 | |
| (712) 629-2975 | |
| Not Available |
| Full Name | Medical Clinic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 710 Center St, Tabor, Iowa |
| Authorized Official Name and Position | Cristin A Hendrickson (CEO) |
| Authorized Official Contact | 7123821515 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medical Clinic Llc 1219 Main St Hamburg IA 51640-1300 Ph: (712) 382-2626 | Medical Clinic Llc 710 Center St Tabor IA 51653-2069 Ph: (712) 629-2975 |
| NPI Number | 1841263233 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/12/2024 |
| Medicare PECOS PAC ID | 5395634216 |
|---|---|
| Medicare Enrollment ID | O20100909001091 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841263233 | NPI | - | NPPES |
| 0018507 | Medicaid | IA | |
| 13034 | Other | IA | WELLMARK BC/BS OF IA |
| 0638361 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Shenandoah Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 713 Main St, Tabor, IA 51653 Phone: 712-246-7400 |