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NPI Code Detail

MEDICARE: FIVE STAR QUALITY CARE-IA INC

MEDICARE: FIVE STAR QUALITY CARE-IA INC
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 Facility770799IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114972577
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIVE STAR QUALITY CARE-IA INC
Provider Business Mailing Address
First Line : 2401 EAST 8TH STREET
Second Line :
City : DES MOINES
State : IA
Zip : 50316-1717
Country : US
Telephone Number : 515-262-9303
Fax Number : 515-262-2506
Provider Business Practice Location Address
First Line : 2401 EAST 8TH STREET
Second Line :
City : DES MOINES
State : IA
Zip : 50316-1717
Country : US
Telephone Number : 515-262-9303
Fax Number : 515-262-2506
Authorized Official
Title or Position : PRESIDENT & CHIEF EXECUTIVE OFFICER
Name : KATHERINE E POTTER
Credential :
Telephone Number : 617-796-8387
Provider Enumeration Date : 05/24/2006
Last Update Date : 03/26/2019

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Directions to “FIVE STAR QUALITY CARE-IA INC ” Practice Location

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