Provider Demographics
NPI:1659362234
Name:EYECARE ASSOCIATES OF SOUTHWEST IOWA INC
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES OF SOUTHWEST IOWA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLOEPFIL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:712-246-1786
Mailing Address - Street 1:505 W SHERIDAN AVE
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:IA
Mailing Address - Zip Code:51601-1705
Mailing Address - Country:US
Mailing Address - Phone:712-246-1786
Mailing Address - Fax:712-246-1182
Practice Address - Street 1:505 W SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:IA
Practice Address - Zip Code:51601-1705
Practice Address - Country:US
Practice Address - Phone:712-246-1786
Practice Address - Fax:712-246-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-02
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
109194OtherEYEMED
IA0201293Medicaid
IA07320OtherBCBS
NE100249544-00Medicaid
109194OtherEYEMED
IA07320OtherBCBS
NE100249544-00Medicaid