Provider Demographics
NPI:1801983010
Name:TYE INC
Entity type:Organization
Organization Name:TYE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DELORES
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:TYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-322-3097
Mailing Address - Street 1:60434 LEVI RD
Mailing Address - Street 2:
Mailing Address - City:GLENWOOD
Mailing Address - State:IA
Mailing Address - Zip Code:51534-5142
Mailing Address - Country:US
Mailing Address - Phone:712-527-9731
Mailing Address - Fax:
Practice Address - Street 1:2600 W BROADWAY
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51501-3512
Practice Address - Country:US
Practice Address - Phone:712-322-3097
Practice Address - Fax:712-322-4130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0797760001Medicare ID - Type Unspecified