Provider Demographics
NPI:1821216326
Name:AUREUS MEDICAL GROUP
Entity Type:Organization
Organization Name:AUREUS MEDICAL GROUP
Other - Org Name:AUREUS MEDICAL GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:ITES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-856-5457
Mailing Address - Street 1:306 MCADOO ST
Mailing Address - Street 2:P O BX 133
Mailing Address - City:WELLSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50680-7675
Mailing Address - Country:US
Mailing Address - Phone:641-869-3949
Mailing Address - Fax:
Practice Address - Street 1:306 MCADOO ST
Practice Address - Street 2:P O BX 133
Practice Address - City:WELLSBURG
Practice Address - State:IA
Practice Address - Zip Code:50680-7675
Practice Address - Country:US
Practice Address - Phone:641-869-3949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA063569251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA063569OtherREGISTERED NURSE