Healthcare Provider Details

I. General information

NPI: 1760782049
Provider Name (Legal Business Name): CNOS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/02/2010
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 HIGHLAND AVE
SAC CITY IA
50583-2424
US

IV. Provider business mailing address

PO BOX 1430
DAKOTA DUNES SD
57049-1430
US

V. Phone/Fax

Practice location:
  • Phone: 605-217-2667
  • Fax: 605-217-2900
Mailing address:
  • Phone: 605-217-2667
  • Fax: 605-217-2900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: QUENTIN J DURWARD
Title or Position: OWNER/BOARD OF DIRECTOR
Credential: MD
Phone: 605-217-2667