Provider Demographics
NPI:1063837383
Name:GREENBELT HOME CARE
Entity Type:Organization
Organization Name:GREENBELT HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-939-8444
Mailing Address - Street 1:2411 EDGINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ELDORA
Mailing Address - State:IA
Mailing Address - Zip Code:50627-1541
Mailing Address - Country:US
Mailing Address - Phone:641-939-8444
Mailing Address - Fax:641-939-8450
Practice Address - Street 1:2411 EDGINGTON AVE
Practice Address - Street 2:
Practice Address - City:ELDORA
Practice Address - State:IA
Practice Address - Zip Code:50627-1541
Practice Address - Country:US
Practice Address - Phone:641-939-8444
Practice Address - Fax:641-939-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0670869Medicaid
IA67056OtherBCBS
IA167056AMedicare PIN