MEDICARE: HEGG MEDICAL CLINIC

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	332B00000X	Durable Medical Equipment & Medical Supplies		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	:	1912077348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEGG MEDICAL CLINIC

Provider Business Mailing Address
First Line	:	2121 HEGG DR
Second Line	:
City	:	ROCK VALLEY
State	:	IA
Zip	:	51247-1445
Country	:	US
Telephone Number	:	712-476-8100
Fax Number	:	712-476-8190

Provider Business Practice Location Address
First Line	:	2121 HEGG DR
Second Line	:
City	:	ROCK VALLEY
State	:	IA
Zip	:	51247-1445
Country	:	US
Telephone Number	:	712-476-8100
Fax Number	:	712-476-8190

Authorized Official
Title or Position	:	BUSINESS OFFICE - AR SUPERVISOR
Name	:	MS. DELORES J VANGROOTHEEST
Credential	:
Telephone Number	:	712-476-8100

Provider Enumeration Date	:	11/09/2006
Last Update Date	:	08/22/2020

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Directions to “HEGG MEDICAL CLINIC ” Practice Location

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