Healthcare Provider Details
I. General information
NPI: 1912032442
Provider Name (Legal Business Name): WOMENS HEALTH SERVICES OF EASTERN IOWA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2635 LINCOLN WAY STE A
CLINTON IA
52732-7203
US
IV. Provider business mailing address
2635 LINCOLN WAY STE A
CLINTON IA
52732-7203
US
V. Phone/Fax
- Phone: 563-243-1413
- Fax: 563-242-9992
- Phone: 563-243-1413
- Fax: 563-242-9992
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332900000X |
| Taxonomy | Non-Pharmacy Dispensing Site |
| License Number | |
| License Number State | IA |
VIII. Authorized Official
Name:
CAROL
MACHAEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 563-243-1413