Healthcare Provider Details

I. General information

NPI: 1467887398
Provider Name (Legal Business Name): MARY GREELEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2013
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1114 DUFF AVE
AMES IA
50010-5739
US

IV. Provider business mailing address

1111 DUFF AVE
AMES IA
50010-5745
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-6730
  • Fax: 515-233-7597
Mailing address:
  • Phone: 515-239-2011
  • Fax: 515-239-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number850040H
License Number StateIA

VIII. Authorized Official

Name: AMBER DEARDORFF
Title or Position: PRESIDENT/CEO
Credential:
Phone: 515-239-2105