MEDICARE: ABCM CORPORATION

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	170382	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	65365	OTHER	IA	WELLMARK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679575278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABCM CORPORATION

Provider Business Mailing Address
First Line	:	1320 4TH ST NE
Second Line	:
City	:	HAMPTON
State	:	IA
Zip	:	50441-1104
Country	:	US
Telephone Number	:	641-456-5636
Fax Number	:	641-456-2320

Provider Business Practice Location Address
First Line	:	400 US HIGHWAY 18 W
Second Line	:
City	:	CLEAR LAKE
State	:	IA
Zip	:	50428-1108
Country	:	US
Telephone Number	:	641-357-5244
Fax Number	:	641-357-7154

Authorized Official
Title or Position	:	CFO
Name	:	TIMOTHY ROBERTS
Credential	:
Telephone Number	:	641-456-5636

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	10/18/2010

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Directions to “ABCM CORPORATION ” Practice Location

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