Organization
PALMER LUTHERAN HEALTH CENTER, INC
Active
Other names
Gundersen Palmer Home Medical Supply
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICE KUENNEN DM (CEO)
(563) 422-3811
Entity
Organization
Contact information
Practice address
230 2ND AVE SE, OELWEIN, IA 50662-2417
(319) 283-4489
(319) 283-1384
Mailing address
230 2ND AVE SE, OELWEIN, IA 50662-2417
(319) 283-4489
(319) 283-1384
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
6397
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0198853
—
IA
01
—
43327
WELLMARK IOWA
IA
Enumeration date
02/10/2006
Last updated
08/03/2022
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