Provider Demographics
NPI:1073763421
Name:ALBERHASKY EYE CLINIC
Entity Type:Organization
Organization Name:ALBERHASKY EYE CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHASE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-337-2220
Mailing Address - Street 1:2346 MORMON TREK BLVD
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4371
Mailing Address - Country:US
Mailing Address - Phone:319-337-2220
Mailing Address - Fax:319-351-1166
Practice Address - Street 1:2346 MORMON TREK BLVD
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-4371
Practice Address - Country:US
Practice Address - Phone:319-337-2220
Practice Address - Fax:319-351-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-23
Last Update Date:2008-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4717830001Medicare NSC