MEDICARE: A NEW IMAGE, 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
1	332B00000X	Durable Medical Equipment & Medical Supplies

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	09017	OTHER	IA	IOWA BLUE CROSS BLUE SHIE

General Provider Information

NPI Number	:	1669470282
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A NEW IMAGE, INC.

Provider Business Mailing Address
First Line	:	1607 HEATH ST
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50703-1930
Country	:	US
Telephone Number	:	319-232-3219
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 HEATH ST
Second Line	:
City	:	WATERLOO
State	:	IA
Zip	:	50703-1930
Country	:	US
Telephone Number	:	319-232-3219
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BARBARA A DANIELS
Credential	:
Telephone Number	:	319-232-3219

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	08/22/2020

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Directions to “A NEW IMAGE, INC. ” Practice Location

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