Provider Demographics
NPI:1912032442
Name:WOMENS HEALTH SERVICES OF EASTERN IOWA INC
Entity Type:Organization
Organization Name:WOMENS HEALTH SERVICES OF EASTERN IOWA INC
Other - Org Name:WOMENS HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-243-1413
Mailing Address - Street 1:2635 LINCOLN WAY
Mailing Address - Street 2:STE A
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-7203
Mailing Address - Country:US
Mailing Address - Phone:563-243-1413
Mailing Address - Fax:563-242-9992
Practice Address - Street 1:2635 LINCOLN WAY
Practice Address - Street 2:STE A
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-7203
Practice Address - Country:US
Practice Address - Phone:563-243-1413
Practice Address - Fax:563-242-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1621451OtherNCPDP