Organization
IOWA EYE PROSTHETICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID MICHAEL BULGARELLI BCO FASO BA (PRESIDENT OCULARIST)
(319) 354-3434
Entity
Organization
Contact information
Practice address
625 FIRST AVENUE, STE 200, CORALVILLE, IA 52241
(319) 354-3434
(319) 354-3465
Mailing address
625 FIRST AVENUE, STE 200, CORALVILLE, IA 52241
(319) 354-3434
(319) 354-3465
Taxonomy
Speciality
Code
Description
License number
State
156FX1700X
Ocularist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0128413
—
IA
01
—
12841
BCBS
—
01
—
40219IO
BCBS OF MN
—
01
—
50796
BCBS
—
01
—
63648
BCBS OF KS
—
01
—
A001983
CHAMPUS
—
Enumeration date
07/12/2006
Last updated
08/22/2020
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