Healthcare Provider Details

I. General information

NPI: 1447470463
Provider Name (Legal Business Name): MARY GREELEY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 DUFF AVE
AMES IA
50010-5745
US

IV. Provider business mailing address

1111 DUFF AVE
AMES IA
50010-5745
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-2011
  • Fax: 515-239-2060
Mailing address:
  • Phone: 515-239-2112
  • Fax: 515-239-2060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number2850100
License Number StateIA

VIII. Authorized Official

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