Provider Demographics
NPI:1336181890
Name:A-1 HOME HEALTHCARE SERVICE CO
Entity Type:Organization
Organization Name:A-1 HOME HEALTHCARE SERVICE CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROSE
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-955-1654
Mailing Address - Street 1:3223 1ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-6001
Mailing Address - Country:US
Mailing Address - Phone:319-362-1084
Mailing Address - Fax:319-366-8972
Practice Address - Street 1:3223 1ST AVE SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-6001
Practice Address - Country:US
Practice Address - Phone:319-362-1084
Practice Address - Fax:319-366-8972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5857332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0254177Medicaid
IA115979OtherBLUE CROSS PROVIDER NO
IA0128439Medicaid
IA115979OtherBLUE CROSS PROVIDER NO