Provider Demographics
NPI:1780776252
Name:PARKVIEW CARE CENTER INC
Entity type:Organization
Organization Name:PARKVIEW CARE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EDMUND
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-472-5022
Mailing Address - Street 1:2237 HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:IA
Mailing Address - Zip Code:52556-8560
Mailing Address - Country:US
Mailing Address - Phone:641-472-5022
Mailing Address - Fax:641-472-6483
Practice Address - Street 1:2237 HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:IA
Practice Address - Zip Code:52556-8560
Practice Address - Country:US
Practice Address - Phone:641-472-5022
Practice Address - Fax:641-472-6483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-29
Last Update Date:2012-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA510388313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0803098Medicaid
IA165306Medicare ID - Type Unspecified