1386162741 NPI number — ACCURA HEALTHCARE OF MARSHALLTOWN LLC

Table of content: (NPI 1386162741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386162741 NPI number — ACCURA HEALTHCARE OF MARSHALLTOWN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ACCURA HEALTHCARE OF MARSHALLTOWN LLC
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:
1386162741
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1603 22ND ST STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WEST DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50266-1410
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-963-1125
Provider Business Mailing Address Fax Number:
515-963-1081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2401 S 2ND ST
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:
50158-4402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-752-1553
Provider Business Practice Location Address Fax Number:
641-752-4125
Provider Enumeration Date:
09/06/2017

Additional Information

Authorized Official

Authorized Official Last Name:
LENEAVE
Authorized Official First Name:
TED
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
515-963-1125

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com