Provider Demographics
NPI:1548249212
Name:MOBILE NURSING SERVICES, LTD.
Entity type:Organization
Organization Name:MOBILE NURSING SERVICES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:319-372-8023
Mailing Address - Street 1:705 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627-2915
Mailing Address - Country:US
Mailing Address - Phone:319-372-8023
Mailing Address - Fax:319-372-8770
Practice Address - Street 1:705 AVENUE G
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-2915
Practice Address - Country:US
Practice Address - Phone:319-372-8023
Practice Address - Fax:319-372-8770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-11
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67157OtherBCBS NUMBER
IA0671578Medicaid
IA167157Medicare ID - Type UnspecifiedMEDICARE NUMBER
IA0671578Medicaid