Provider Demographics
NPI:1710485123
Name:STATE UNIVERSITY OF IOWA
Entity Type:Organization
Organization Name:STATE UNIVERSITY OF IOWA
Other - Org Name:IOWA LIONS EYE BANK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:RN, PHD
Authorized Official - Phone:319-335-4888
Mailing Address - Street 1:2500 CROSSPARK RD STE W300
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-4710
Mailing Address - Country:US
Mailing Address - Phone:319-335-4888
Mailing Address - Fax:319-335-4622
Practice Address - Street 1:2500 CROSSPARK RD STE W300
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-4710
Practice Address - Country:US
Practice Address - Phone:319-335-4888
Practice Address - Fax:319-335-4622
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STATE UNIVERSITY OF IOWA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-31
Last Update Date:2018-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332G00000XSuppliersEye Bank