Organization
HEARTLAND ONCOLOGY & HEMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY A. MALCOM (ADMINISTRATOR)
(712) 322-4136
Entity
Organization
Contact information
Practice address
1 EDMUNDSON PL, SUITE 100, COUNCIL BLUFFS, IA 51503-4658
(712) 322-4136
(712) 322-8129
Mailing address
1 EDMUNDSON PL, SUITE 100, COUNCIL BLUFFS, IA 51503-4658
(712) 322-4136
(712) 322-8129
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
9701
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0197939
—
IA
01
—
G9534
RR MEDICARE
IA
Enumeration date
07/03/2006
Last updated
10/06/2015
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