Provider Demographics
NPI:1285809095
Name:TOPS II, LLC
Entity type:Organization
Organization Name:TOPS II, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ELLERBROEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-224-8678
Mailing Address - Street 1:2800 PIERCE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51104-3755
Mailing Address - Country:US
Mailing Address - Phone:712-224-8678
Mailing Address - Fax:712-277-1662
Practice Address - Street 1:2800 PIERCE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3755
Practice Address - Country:US
Practice Address - Phone:712-224-8678
Practice Address - Fax:712-277-1662
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TRI-STATE ORTHOPAEDIC PHYSICIANS, PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-23
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA350225261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1285809095Medicaid
IADN3643OtherMEDICARE RR
IADN3643OtherMEDICARE RR
IA6199290001Medicare NSC