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NPI Code Detail

MEDICARE: U.S.A. HEALTHCARE CENTER-URBANDALE, L.L.C.

MEDICARE: U.S.A. HEALTHCARE CENTER-URBANDALE, L.L.C.
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 Facility770053IA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
165580OTHERIABCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275530883
Entity Type Code : Organization
Provider Name (Legal Business Name) : U.S.A. HEALTHCARE CENTER-URBANDALE, L.L.C.
Provider Business Mailing Address
First Line : 4614 84TH ST
Second Line :
City : URBANDALE
State : IA
Zip : 50322-1089
Country : US
Telephone Number : 515-278-6838
Fax Number : 515-278-5693
Provider Business Practice Location Address
First Line : 4614 84TH ST
Second Line :
City : URBANDALE
State : IA
Zip : 50322-1089
Country : US
Telephone Number : 515-278-6838
Fax Number : 515-278-5693
Authorized Official
Title or Position : C.F.O.
Name : MR. JEFF HUTTON
Credential :
Telephone Number : 256-739-1239
Provider Enumeration Date : 06/29/2005
Last Update Date : 04/14/2008

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