1831199397 NPI number — ADVANTAGE NURSING SERVICES OF IOWA, INC.

Table of content: (NPI 1831199397)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831199397 NPI number — ADVANTAGE NURSING SERVICES OF IOWA, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANTAGE NURSING SERVICES OF IOWA, INC.
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:
6
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:
1831199397
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2127 INNERBELT BUSINESS CENTER DR.
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SAINT LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63114-5718
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-991-3166
Provider Business Mailing Address Fax Number:
314-991-2404

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
207 E. MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KNOXVILLE
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50138-2526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-828-7709
Provider Business Practice Location Address Fax Number:
641-842-6908
Provider Enumeration Date:
07/27/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MAHON
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
314-991-3166

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  167241 , 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: 0672410 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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