Provider Demographics
NPI:1740700533
Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Entity type:Organization
Organization Name:IOWA PHYSICIANS CLINIC MEDICAL FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:BAEDKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-574-6112
Mailing Address - Street 1:800 S FILLMORE ST STE A
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:IA
Mailing Address - Zip Code:50213-1619
Mailing Address - Country:US
Mailing Address - Phone:641-342-2128
Mailing Address - Fax:641-342-3179
Practice Address - Street 1:800 S FILLMORE ST STE A
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:IA
Practice Address - Zip Code:50213-1619
Practice Address - Country:US
Practice Address - Phone:641-342-2128
Practice Address - Fax:641-342-3179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1366425274Medicaid