Provider Demographics
NPI:1306815733
Name:FAMILY MEDICAL INC.
Entity Type:Organization
Organization Name:FAMILY MEDICAL INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-476-2600
Mailing Address - Street 1:606 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:DYSART
Mailing Address - State:IA
Mailing Address - Zip Code:52224
Mailing Address - Country:US
Mailing Address - Phone:319-476-2600
Mailing Address - Fax:319-476-2601
Practice Address - Street 1:606 WILSON ST
Practice Address - Street 2:
Practice Address - City:DYSART
Practice Address - State:IA
Practice Address - Zip Code:52224
Practice Address - Country:US
Practice Address - Phone:319-476-2600
Practice Address - Fax:319-476-2601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4736430001Medicare NSC