Healthcare Provider Details

I. General information

NPI: 1891771663
Provider Name (Legal Business Name): MMSC VENTURES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 12/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 3RD AVE SW
STATE CENTER IA
50247-7719
US

IV. Provider business mailing address

3 SOUTH 4TH AVENUE
MARSHALLTOWN IA
50158-2998
US

V. Phone/Fax

Practice location:
  • Phone: 641-483-2141
  • Fax:
Mailing address:
  • Phone: 641-754-5151
  • Fax: 641-754-5181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT L. DOWNEY
Title or Position: VICE PRESIDENT OF FINANCE
Credential:
Phone: 641-754-5125