- Enrollment id
- O20080303000181
- Enrollment state
- IA
- Provider type code
- 00-08
- Provider type text
- PART A PROVIDER - HOSPICE
- Npi
- 1457337263
- Multiple npi flag
- N
- Ccn
- 161508
- Associate id
- 6507769247
- Organization name
- MARY GREELEY MEDICAL CENTER
- Doing business as name
- MARY GREELEY HOSPICE SERVICES
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Address line 1
- 1111 DUFF AVE
- City
- AMES
- State
- IA
- Zip code
- 500105745