National Provider Identifier Database

MARYS CARE MEMORIAL CLINIC
Primary Care


Contact Information

MARY'S CARE MEMORIAL CLINIC
210 W 1ST ST
WALL LAKE, IA51466-7726
Phone: 712-790-6033
Fax:
Website:
Specialty Taxonomy Code
* Primary Care 261QP2300X

* Indicates primary specialty

NPI Profile & details for MARY'S CARE MEMORIAL CLINIC

NPI Number 1033736871
Legal business name
LBN
MARY'S CARE MEMORIAL CLINIC
Authorized official KAREN PHILLIPS - (CREDENTIALER)
Entity Organization
Organization subpart No
Enumeration date 06/27/2020
Last updated 06/27/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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