Provider Demographics
NPI:1700657814
Name:THE IOWA CLINIC, PC
Entity Type:Organization
Organization Name:THE IOWA CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARP
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:515-875-9876
Mailing Address - Street 1:PO BOX 424
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50302-0424
Mailing Address - Country:US
Mailing Address - Phone:515-875-9225
Mailing Address - Fax:515-875-9223
Practice Address - Street 1:1025 SE TALLGRASS LANE
Practice Address - Street 2:STE 210
Practice Address - City:WAUKEE
Practice Address - State:IA
Practice Address - Zip Code:50263-6816
Practice Address - Country:US
Practice Address - Phone:515-875-9908
Practice Address - Fax:515-875-9882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies