Healthcare Provider Details

I. General information

NPI: 1205281367
Provider Name (Legal Business Name): ABCM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/26/2016
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2603 17TH ST
EMMETSBURG IA
50536-2032
US

IV. Provider business mailing address

1320 4TH ST NE
HAMPTON IA
50441-1104
US

V. Phone/Fax

Practice location:
  • Phone: 712-852-4266
  • Fax: 712-852-4662
Mailing address:
  • Phone: 641-456-5636
  • Fax: 641-456-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. TIMOTHY ROBERTS
Title or Position: CFO
Credential:
Phone: 641-456-5636