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NPI Code Detail

MEDICARE: OPCO IOWA CITY, IA, LLC

MEDICARE: OPCO IOWA CITY, IA, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility

General Provider Information

NPI Number : 1053140111
Entity Type Code : Organization
Provider Name (Legal Business Name) : OPCO IOWA CITY, IA, LLC
Provider Business Mailing Address
First Line : 2045 W GRAND AVE STE B-34572
Second Line :
City : CHICAGO
State : IL
Zip : 60612-1576
Country : US
Telephone Number : 872-282-8001
Fax Number :
Provider Business Practice Location Address
First Line : 3661 ROCHESTER AVE
Second Line :
City : IOWA CITY
State : IA
Zip : 52245-9271
Country : US
Telephone Number : 319-351-7460
Fax Number :
Authorized Official
Title or Position : MANAGER OF THE LLC
Name : ISAAC DOLE
Credential :
Telephone Number : 872-282-8001
Provider Enumeration Date : 07/29/2024
Last Update Date : 05/28/2026

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Directions to “OPCO IOWA CITY, IA, LLC ” Practice Location

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