Healthcare Provider Details
I. General information
NPI: 1003818428
Provider Name (Legal Business Name): ABCM CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/15/2005
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1212 S STUART ST
SIGOURNEY IA
52591-1307
US
IV. Provider business mailing address
1320 4TH ST NE
HAMPTON IA
50441-1104
US
V. Phone/Fax
- Phone: 641-622-2142
- Fax: 641-622-2181
- Phone: 641-456-5636
- Fax: 641-456-2320
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | 540119 |
| License Number State | IA |
VIII. Authorized Official
Name:
RICHARD
ALLBEE
Title or Position: CEO
Credential:
Phone: 641-456-5636