Provider Demographics
NPI:1205908563
Name:CANCER CARE OF IOWA CITY LLC
Entity type:Organization
Organization Name:CANCER CARE OF IOWA CITY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRES/NURSING
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:L
Authorized Official - Last Name:PENNEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-339-3917
Mailing Address - Street 1:613 E BLOOMINGTON ST
Mailing Address - Street 2:SUITE 100 CANCER CARE OF IOWA CITY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52245
Mailing Address - Country:US
Mailing Address - Phone:319-339-3917
Mailing Address - Fax:319-358-2794
Practice Address - Street 1:613 E BLOOMINGTON
Practice Address - Street 2:SUITE 100 CANCER CARE OF IOWA CITY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245
Practice Address - Country:US
Practice Address - Phone:319-339-3917
Practice Address - Fax:319-358-2794
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty