Provider Demographics
NPI:1801210711
Name:C R IV SERVICE INC
Entity Type:Organization
Organization Name:C R IV SERVICE INC
Other - Org Name:ADVANCE HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ALBERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-363-4554
Mailing Address - Street 1:402 10TH ST SE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52403-2403
Mailing Address - Country:US
Mailing Address - Phone:319-247-7200
Mailing Address - Fax:319-247-7202
Practice Address - Street 1:402 10TH ST SE
Practice Address - Street 2:SUITE 100
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52403-2403
Practice Address - Country:US
Practice Address - Phone:319-247-7200
Practice Address - Fax:319-247-7202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA11023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy