OrganizationActive
Countryside Medical Clinic, LLC
NPI 1396103685 · Primary Care Clinic/Center · Red Oak, IA
Provider details
- NPI number
- 1396103685
- Entity type
- Organization
- Primary specialty
- Primary Care Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Kimberly Rines, Nurse Practitioner(712) 629-0040
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
1959 200th St
Red Oak, IA 51566-3218
Phone: (712) 629-0040
Fax: (712) 566-5049
Approximate (ZIP-level) locationGet directions
Mailing address
1959 200th St
Red Oak, IA 51566-3218
Registry dates
- Enumerated
- 2016-02-02
- Last updated
- 2018-12-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.