Healthcare Provider Details

I. General information

NPI: 1477924025
Provider Name (Legal Business Name): MMS-GREENE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2015
Last Update Date: 07/03/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 S HIGH ST
GREENE IA
50636
US

IV. Provider business mailing address

108 S HIGH ST
GREENE IA
50636-9437
US

V. Phone/Fax

Practice location:
  • Phone: 641-823-4531
  • Fax:
Mailing address:
  • Phone: 641-823-4531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number120718
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MICHAEL STEINKRUGER
Title or Position: OWNER
Credential: RN,ADM
Phone: 319-430-4405