Provider Demographics
NPI:1477844579
Name:IADAKNE MEDICAL
Entity Type:Organization
Organization Name:IADAKNE MEDICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:KREITEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-889-7243
Mailing Address - Street 1:3212 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57103-2105
Mailing Address - Country:US
Mailing Address - Phone:402-889-7243
Mailing Address - Fax:
Practice Address - Street 1:3212 E 10TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57103-2105
Practice Address - Country:US
Practice Address - Phone:888-481-7269
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies