Provider Demographics
NPI:1043213317
Name:MARSHALLTOWN MEDICAL & SURGICAL CENTER
Entity Type:Organization
Organization Name:MARSHALLTOWN MEDICAL & SURGICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:DOWNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-754-5125
Mailing Address - Street 1:3 SOUTH 4TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-2998
Mailing Address - Country:US
Mailing Address - Phone:641-754-5151
Mailing Address - Fax:641-754-5181
Practice Address - Street 1:3 SOUTH 4TH AVENUE
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158-2998
Practice Address - Country:US
Practice Address - Phone:641-754-5151
Practice Address - Fax:641-754-5181
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-31
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA64000314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA165125Medicare Oscar/Certification