Provider Demographics
NPI:1447415260
Name:ALGONA PODIATRY
Entity Type:Organization
Organization Name:ALGONA PODIATRY
Other - Org Name:FAMILY FOOT CARE CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:R
Authorized Official - Last Name:REINKING
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:515-295-9644
Mailing Address - Street 1:1318 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ALGONA
Mailing Address - State:IA
Mailing Address - Zip Code:50511-1822
Mailing Address - Country:US
Mailing Address - Phone:515-295-9644
Mailing Address - Fax:515-295-9644
Practice Address - Street 1:1318 N MAIN ST
Practice Address - Street 2:
Practice Address - City:ALGONA
Practice Address - State:IA
Practice Address - Zip Code:50511-1822
Practice Address - Country:US
Practice Address - Phone:515-295-9644
Practice Address - Fax:515-295-9644
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-21
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA509261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0018127Medicaid
IA01812Medicare PIN
IAIB1155Medicare PIN
IAU09709Medicare UPIN
IAIB1156Medicare PIN