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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
200 JEFFERSON ST, LOWER LEVEL, WEST UNION, IA 52175-1024
(563) 422-9714
(563) 422-9875
Mailing address
200 JEFFERSON ST, LOWER LEVEL, WEST UNION, IA 52175-1024
(563) 422-9714
(563) 422-9875

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
6396
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0112599
IA
01
43326
WELLMARK OF IOWA
IA
Enumeration date
02/10/2006
Last updated
11/29/2018
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