MARTIN HEALTH SERVICES INC (MARTIN HEALTH SERVICES INC) - NPI NUMBER 1699949560

Summary

Provider Name: MARTIN HEALTH SERVICES INC (MARTIN HEALTH SERVICES INC)

NPI Number: 1699949560

Clasification: Pharmacy (3336L0003X)

Specialization: Long Term Care Pharmacy

Address:
5500 WEST PARKWAY
JOHNSTON, IA
ZIP 50131

Phone Number: (515) 986-3054



Detailed Information

MARTIN HEALTH SERVICES INC is a long term care pharmacy pharmacy in Johnston, IA. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. The assigned NPI number for this provider is 1699949560 and is registered as an organization entity type.
The provider Is Doing Business As Martin Health Services Inc.

The provider's business address is:

5500 WEST PARKWAY
JOHNSTON, IA
ZIP 50131
Phone: (515) 986-3054
Fax: (515) 986-3679

The provider's authorized official is Tina Moeller .
The authorized official title is President and has the following contact phone number (319) 984-5680.

The enumeration date for this NPI number is 4/22/2008 and was last updated on 2/12/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 3336L0003X Pharmacy Long Term Care Pharmacy 1343 IA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 2030477 OTHER PK
2 0702105 MEDICAID IA

NPI Record

No. Field Name Field Value
1 NPI 1699949560
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name MARTIN HEALTH SERVICES INC
5 Provider Other Organization Name MARTIN HEALTH SERVICES INC
6 Provider Other Organization Name Type Code 3
7 Provider First Line Business Practice Location Address 5500 WEST PARKWAY
8 Provider Business Practice Location Address City Name JOHNSTON
9 Provider Business Practice Location Address State Name IA
10 Provider Business Practice Location Address Postal Code 50131
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 5159863054
13 Provider Business Practice Location Address Fax Number 5159863679
14 Provider Enumeration Date 4/22/2008
15 Last Update Date 2/12/2014
16 Authorized Official Last Name MOELLER
17 Authorized Official First Name TINA
18 Authorized Official Title or Position PRESIDENT
19 Authorized Official Telephone Number 3199845680
20 Healthcare Provider Taxonomy Code 1 3336L0003X
21 Provider License Number 1 1343
22 Provider License Number State Code 1 IA
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Other Provider Identifier 1 2030477
25 Other Provider Identifier Type Code 1 01
26 Other Provider Identifier Issuer 1 PK
27 Other Provider Identifier 2 0702105
28 Other Provider Identifier Type Code 2 05
29 Other Provider Identifier State 2 IA
30 Is Organization Subpart N

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This page was last updated on: 7/15/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.