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NPI Code Detail

MEDICARE: FRED MATHEWS INC.

MEDICARE: FRED MATHEWS INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
116397OTHERIABLUE CROSS/BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285613414
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRED MATHEWS INC.
Provider Business Mailing Address
First Line : PO BOX 8
Second Line :
City : WAUKON
State : IA
Zip : 52172-0008
Country : US
Telephone Number : 563-568-6004
Fax Number : 563-568-6139
Provider Business Practice Location Address
First Line : 40 1ST ST SE
Second Line :
City : WAUKON
State : IA
Zip : 52172-2022
Country : US
Telephone Number : 563-568-6004
Fax Number : 563-568-6139
Authorized Official
Title or Position : PRESIDENT
Name : MR. FRED JAY MATHEWS
Credential : RRT
Telephone Number : 563-568-6004
Provider Enumeration Date : 01/16/2006
Last Update Date : 08/22/2020

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