1184729063 NPI number — THE COMMUNITY NURSING SERVICE

Table of content: (NPI 1184729063)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184729063 NPI number — THE COMMUNITY NURSING SERVICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE COMMUNITY NURSING SERVICE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184729063
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1202
Provider Second Line Business Mailing Address:
11 NORTH 1ST AVENUE
Provider Business Mailing Address City Name:
MARSHALLTOWN
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50158-1202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-752-4611
Provider Business Mailing Address Fax Number:
641-752-5404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 N 1ST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MARSHALLTOWN
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50158-4902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-752-4611
Provider Business Practice Location Address Fax Number:
641-752-5404
Provider Enumeration Date:
09/14/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
AVES
Authorized Official First Name:
DELAINE
Authorized Official Middle Name:
Authorized Official Title or Position:
AGENCY DIRECTOR
Authorized Official Telephone Number:
641-752-4611

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0670992 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 67099 . This is a "WELLMARK BC/BS OF IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".