| Medical Clinic LLC | |
|
313 Main St Sidney IA 51652-8036 | |
| (712) 374-2649 | |
| Not Available |
| Full Name | Medical Clinic LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 313 Main St, Sidney, 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 313 Main St Sidney IA 51652-8036 Ph: (712) 374-2649 |
| NPI Number | 1871566265 |
|---|---|
| Provider Enumeration Date | 02/08/2006 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Medicare PECOS PAC ID | 5395634216 |
|---|---|
| Medicare Enrollment ID | O20101008000771 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871566265 | NPI | - | NPPES |
| 0638338 | Medicaid | IA | |
| 0018507 | Medicaid | IA | |
| 13046 | Other | IA | WELLMARK BC/BS OF IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
Shenandoah Physicians Clinic-sidney Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 802 Illinois St, Sidney, IA 51652 Phone: 712-374-6005 Fax: 712-374-3100 |
Shenandoah Physicians Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 802 Illinois St, Sidney, IA 51652 Phone: 712-374-6005 Fax: 712-374-2301 |