| Proteus Inc. | |
|
1221 Center St Ste 16 Des Moines IA 50309-1000 | |
| (515) 271-5303 | |
| (515) 271-5309 |
| Full Name | Proteus Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1221 Center St Ste 16, Des Moines, Iowa |
| Authorized Official Name and Position | Jesus Soto (CEO) |
| Authorized Official Contact | 5153486646 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Proteus Inc. 1221 Center St Ste 16 Des Moines IA 50309-1014 Ph: (515) 271-5306 | Proteus Inc. 1221 Center St Ste 16 Des Moines IA 50309-1000 Ph: (515) 271-5303 |
| NPI Number | 1497984579 |
|---|---|
| Provider Enumeration Date | 07/09/2009 |
| Last Update Date | 05/02/2018 |
| Medicare PECOS PAC ID | 2264569284 |
|---|---|
| Medicare Enrollment ID | O20100616000158 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497984579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Iowa) | Primary |
| 261QM1000X | Clinic/center - Migrant Health | (NU) | Secondary |
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