Provider Demographics
NPI:1093912164
Name:ANDERSON SERVICES, LLC
Entity Type:Organization
Organization Name:ANDERSON SERVICES, LLC
Other - Org Name:HOUSE DOCTORS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAMIE
Authorized Official - Middle Name:F
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-287-8014
Mailing Address - Street 1:2201 FALLS AVE
Mailing Address - Street 2:
Mailing Address - City:WATERLOO
Mailing Address - State:IA
Mailing Address - Zip Code:50701-5705
Mailing Address - Country:US
Mailing Address - Phone:319-287-8014
Mailing Address - Fax:319-287-9486
Practice Address - Street 1:2201 FALLS AVE
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50701-5705
Practice Address - Country:US
Practice Address - Phone:319-287-8014
Practice Address - Fax:319-287-9486
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0195545Medicaid