Provider Demographics
NPI:1376849125
Name:IADAKNE MEDICAL
Entity Type:Organization
Organization Name:IADAKNE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KREITEL
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:402-889-7243
Mailing Address - Street 1:495 SE ALICES RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:WAUKEE
Mailing Address - State:IA
Mailing Address - Zip Code:50263-9634
Mailing Address - Country:US
Mailing Address - Phone:402-889-7243
Mailing Address - Fax:515-864-0222
Practice Address - Street 1:495 SE ALICES RD
Practice Address - Street 2:SUITE A
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-9634
Practice Address - Country:US
Practice Address - Phone:402-889-7243
Practice Address - Fax:515-864-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies