Provider Demographics
NPI:1285230789
Name:IDRIS, AMAR MUSA (HOMECARE AGENCY)
Entity Type:Individual
Prefix:
First Name:AMAR
Middle Name:MUSA
Last Name:IDRIS
Suffix:
Gender:M
Credentials:HOMECARE AGENCY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 ROBERTS RD APT 2B
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2739
Mailing Address - Country:US
Mailing Address - Phone:319-800-8180
Mailing Address - Fax:
Practice Address - Street 1:2650 ROBERTS RD APT 2B
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2739
Practice Address - Country:US
Practice Address - Phone:319-800-8180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide