MEDICARE: ABCM CORPORATION

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	261QR0400X	Rehabilitation Clinic/Center		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

General Provider Information

NPI Number	:	1457422891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABCM CORPORATION

Provider Business Mailing Address
First Line	:	1320 4TH ST NE
Second Line	:
City	:	HAMPTON
State	:	IA
Zip	:	50441-1104
Country	:	US
Telephone Number	:	641-456-5636
Fax Number	:	641-456-2320

Provider Business Practice Location Address
First Line	:	215 HIGHWAY 30 SW
Second Line	:
City	:	MOUNT VERNON
State	:	IA
Zip	:	52314-1561
Country	:	US
Telephone Number	:	319-895-8891
Fax Number	:	319-895-6476

Authorized Official
Title or Position	:	CFO
Name	:	TIMOTHY ROBERTS
Credential	:
Telephone Number	:	641-456-5636

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	10/12/2009

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