Healthcare Provider Details

I. General information

NPI: 1740282391
Provider Name (Legal Business Name): ABCM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 W 3RD PL
INDIANOLA IA
50125-2104
US

IV. Provider business mailing address

1320 4TH ST NE
HAMPTON IA
50441-1104
US

V. Phone/Fax

Practice location:
  • Phone: 515-961-3189
  • Fax: 515-962-1288
Mailing address:
  • Phone: 641-456-5636
  • Fax: 641-456-2320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number910176
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: RICHARD ALBERT ALLBEE
Title or Position: CHAIRMAN & CEO
Credential:
Phone: 641-456-5636