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General NPI Number Information
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NPI Number | 1114938412
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Entity Type | Organization
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Legal Business Name | EASTERN IOWA VISITING NURSES AND HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 221 E 1ST ST
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City | MONTICELLO
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State | IA
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Zip | 52310-1592
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Country | US
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Telephone | 319-465-6299
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Fax | 319-465-6317
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Provider Business Mailing Address
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Address Line | 221 E 1ST ST
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City | MONTICELLO
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State | IA
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Zip | 52310-1592
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Country | US
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Telephone | 319-465-6299
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Fax | 319-465-6317
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. LINDA D FANTON
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Credential | RN
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Telephone | 319-465-6299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 167262A
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License Number State | IA
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