Healthcare Provider Details

I. General information

NPI: 1477682540
Provider Name (Legal Business Name): IOWA BLOOD AND CANCER CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 06/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

855 A AVE NE SUITE 420
CEDAR RAPIDS IA
52402-5057
US

IV. Provider business mailing address

PO BOX 3178
CEDAR RAPIDS IA
52406-3178
US

V. Phone/Fax

Practice location:
  • Phone: 319-297-2900
  • Fax: 319-297-2969
Mailing address:
  • Phone: 319-399-2096
  • Fax: 319-399-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License NumberNABP# 1623758
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: SANDRA J SPARENBORG
Title or Position: FINANCE DIRECTOR
Credential:
Phone: 319-398-1563