Organization Name: | PHYSICIANS CLINIC, INC. |
NPI Number: | 1023105855 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TODD D. GRAGES (PRESIDENT) |
Mailing Address: | 320 Ebaugh Street Glenwood |
State: | IA US |
Postal Code: | 51534 |
Phone Number: | 7125275204 |
Fax Number: | 7125279346 |
NPI Enumeration Date: | 10/05/2006 |
NPI Last Update Date: | 10/07/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332B00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | |
Taxonomy Definition: | A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient |