MEDICARE: AMERICAN BAPTIST HOMES OF THE MIDWEST

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	314000000X	Skilled Nursing Facility		IA

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1538157268
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN BAPTIST HOMES OF THE MIDWEST

Provider Business Mailing Address
First Line	:	807 5TH ST
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-3303
Country	:	US
Telephone Number	:	641-228-1612
Fax Number	:	641-228-6747

Provider Business Practice Location Address
First Line	:	807 5TH ST
Second Line	:
City	:	CHARLES CITY
State	:	IA
Zip	:	50616-3303
Country	:	US
Telephone Number	:	641-228-1612
Fax Number	:	641-228-6747

Authorized Official
Title or Position	:	DIRECTOR OF REIMBURSEMENT
Name	:	DEBORAH A KOTCHER
Credential	:
Telephone Number	:	952-253-1485

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	07/21/2022

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Directions to “AMERICAN BAPTIST HOMES OF THE MIDWEST ” Practice Location

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