MEDICARE: MASON CITY HEALTHCARE

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
1	314000000X	Skilled Nursing Facility	170364	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	65139	OTHER	IA	BCBS PROV#

General Provider Information

NPI Number	:	1427055037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MASON CITY HEALTHCARE

Provider Business Mailing Address
First Line	:	222 S PIERCE AVE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-2748
Country	:	US
Telephone Number	:	641-423-3355
Fax Number	:	641-423-7006

Provider Business Practice Location Address
First Line	:	222 S PIERCE AVE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-2748
Country	:	US
Telephone Number	:	641-423-3355
Fax Number	:	641-423-7006

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. RACHEL RICHARDSON
Credential	:
Telephone Number	:	641-423-3355

Provider Enumeration Date	:	06/29/2005
Last Update Date	:	08/22/2020

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Directions to “MASON CITY HEALTHCARE ” Practice Location

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