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Organization
GENGASTRO LLC
Active
Organization
GENGASTRO LLC
Active
Other names
Endoscopy Center for Digestive Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAIGE TAGUE (LEAD INSURANCE BILLER)
(563) 383-2686
Entity
Organization
Contact information
Practice address
2222 53RD AVE, BETTENDORF, IA 52722-7546
(563) 383-2686
(563) 884-8144
Mailing address
2222 53RD AVE, BETTENDORF, IA 52722-7546
(563) 383-2686
(563) 884-8144
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IA
261QE0800X
Endoscopy Clinic/Center
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610279
—
IA
01
—
1603165
CSA
IA
Enumeration date
11/30/2005
Last updated
03/07/2023
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