Basic Information
| Provider Information | |||||||||
| NPI: | 1477682540 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | IOWA BLOOD AND CANCER CARE | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3178 | ||||||||
| Address2: | |||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524063178 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3193992096 | ||||||||
| FaxNumber: | 3193992036 | ||||||||
| Practice Location | |||||||||
| Address1: | 855 A AVE NE | ||||||||
| Address2: | SUITE 420 | ||||||||
| City: | CEDAR RAPIDS | ||||||||
| State: | IA | ||||||||
| PostalCode: | 524025057 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3192972900 | ||||||||
| FaxNumber: | 3192972969 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/05/2007 | ||||||||
| LastUpdateDate: | 06/09/2011 | ||||||||
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| AuthorizedOfficialLastName: | SPARENBORG | ||||||||
| AuthorizedOfficialFirstName: | SANDRA | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | FINANCE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 3193981563 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | PHYSICIANS' CLINIC OF IOWA, PC | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332900000X | NABP# 1623758 | IA | N | Suppliers | Non-Pharmacy Dispensing Site | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.