Provider Demographics
NPI:1861525255
Name:SKIFF MEDICAL CENTER
Entity type:Organization
Organization Name:SKIFF MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:641-792-5086
Mailing Address - Street 1:204 N 4TH AVE E
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:IA
Mailing Address - Zip Code:50208-3135
Mailing Address - Country:US
Mailing Address - Phone:641-792-5086
Mailing Address - Fax:641-791-4813
Practice Address - Street 1:204 N 4TH AVE E
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:IA
Practice Address - Zip Code:50208-3135
Practice Address - Country:US
Practice Address - Phone:641-792-5086
Practice Address - Fax:641-791-4813
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SKIFF MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-14
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA07003OtherBCBS DME
IA047889Medicare Oscar/Certification