Organization
MEDIAPOLIS CARE FACILITY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RUSSELL RAY HUTCHINSON (ADMINISTRATOR OWNER)
(319) 394-3432
Entity
Organization
Contact information
Practice address
142 N ORCHARD, MEDIAPOLIS, IA 52637
(319) 394-3432
(319) 394-3732
Mailing address
PO BOX 129, 142 N ORCHARD, MEDIAPOLIS, IA 52637
(319) 394-3432
(319) 394-3732
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
R0360
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0894931
—
IA
01
—
2003358
IOWA ACET
IA
Enumeration date
12/13/2006
Last updated
07/03/2012
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