MEDICARE: MMSC VENTURES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316924848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MMSC VENTURES INC

Provider Business Mailing Address
First Line	:	1307 S BROADWAY ST
Second Line	:
City	:	TOLEDO
State	:	IA
Zip	:	52342-2307
Country	:	US
Telephone Number	:	641-484-4449
Fax Number	:

Provider Business Practice Location Address
First Line	:	1307 S BROADWAY ST
Second Line	:
City	:	TOLEDO
State	:	IA
Zip	:	52342-2307
Country	:	US
Telephone Number	:	641-484-4449
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	MR. ROBERT B. COOPER
Credential	:
Telephone Number	:	641-754-5145

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	12/03/2008

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