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General NPI Number Information
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NPI Number | 1255568804
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, INC
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Dates
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Enumeration Date | 06/22/2009
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Last Update Date | 06/22/2009
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Provider Practice Location Address
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Address Line | 218 N 2ND ST
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City | WAPELLO
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State | IA
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Zip | 52653-1202
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Country | US
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Telephone | 319-523-8205
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Fax | 319-523-8840
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Provider Business Mailing Address
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Address Line | 218 N 2ND ST
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City | WAPELLO
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State | IA
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Zip | 52653-1202
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Country | US
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Telephone | 319-523-8205
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Fax | 319-523-8840
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. TERRY J. PROTEXTOR
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Credential |
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Telephone | 319-337-7642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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