MEDICARE: CITY OF CENTRAL CITY

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	332U00000X	Home Delivered Meals		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

General Provider Information

NPI Number	:	1619145919
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CENTRAL CITY

Provider Business Mailing Address
First Line	:	137 4TH ST N
Second Line	:	SUITE 3
City	:	CENTRAL CITY
State	:	IA
Zip	:	52214-9596
Country	:	US
Telephone Number	:	319-438-6691
Fax Number	:	319-438-1308

Provider Business Practice Location Address
First Line	:	137 4TH ST N
Second Line	:	SUITE 3
City	:	CENTRAL CITY
State	:	IA
Zip	:	52214-9596
Country	:	US
Telephone Number	:	319-438-6691
Fax Number	:	319-438-1308

Authorized Official
Title or Position	:	CITY ADMINISTRATOR
Name	:	LANEIL MCFADDEN
Credential	:
Telephone Number	:	319-438-6691

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	02/20/2008

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Directions to “CITY OF CENTRAL CITY ” Practice Location

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