Provider Demographics
NPI:1831199397
Name:ADVANTAGE NURSING SERVICES OF IOWA, INC.
Entity type:Organization
Organization Name:ADVANTAGE NURSING SERVICES OF IOWA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:MAHON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-991-3166
Mailing Address - Street 1:2127 INNERBELT BUSINESS CENTER DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-5718
Mailing Address - Country:US
Mailing Address - Phone:314-991-3166
Mailing Address - Fax:314-991-2404
Practice Address - Street 1:207 E. MAIN STREET
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-2526
Practice Address - Country:US
Practice Address - Phone:641-828-7709
Practice Address - Fax:641-842-6908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-27
Last Update Date:2011-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA167241251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0672410Medicaid
IA167241Medicare Oscar/Certification