MEDICARE: IOWA MEDICINE LLC

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	251B00000X	Case Management Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1427602614
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IOWA MEDICINE LLC

Provider Business Mailing Address
First Line	:	PO BOX 50008
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55405-0008
Country	:	US
Telephone Number	:	612-325-5522
Fax Number	:

Provider Business Practice Location Address
First Line	:	1150 5TH ST STE 276
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-2914
Country	:	US
Telephone Number	:	443-254-8854
Fax Number	:

Authorized Official
Title or Position	:	PAYROLL MANAGER
Name	:	AHMAD SAAD
Credential	:
Telephone Number	:	612-325-5522

Provider Enumeration Date	:	07/26/2019
Last Update Date	:	07/26/2019

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Directions to “IOWA MEDICINE LLC ” Practice Location

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