Organization
COMMUNITY HEALTH CENTERS OF SOUTHEASTERN IOWA INC
Active
Other names
Tri-State Medical Group Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. APRIL K SCHNEDLER (LEAD BILLING COORDINATOR)
(319) 768-5809
Entity
Organization
Contact information
Practice address
1425 MORGAN ST, KEOKUK, IA 52632-4027
(217) 256-3013
(319) 753-2301
Mailing address
1706 WEST AGENCY ROAD, WEST BURLINGTON, IA 52655
(319) 768-5858
(319) 753-2301
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0786558
—
IA
01
—
33624
BLUE CROSS BLUE SHIELD
IA
05
—
506089440
—
MO
Enumeration date
03/28/2006
Last updated
01/11/2012
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