Organization
WESTERN HOME
Active
Other names
Elizabeth E. Martin Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY L. HARRIS (PRESIDENT)
(319) 277-2141
Entity
Organization
Contact information
Practice address
420 E 11TH ST, CEDAR FALLS, IA 50613-3364
(319) 277-2141
(319) 268-8338
Mailing address
420 E 11TH ST, CEDAR FALLS, IA 50613-3364
(319) 277-2141
(319) 268-8338
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
332BN1400X
Nursing Facility Supplies (DME)
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0166140
DME
IA
Enumeration date
05/25/2007
Last updated
04/23/2009
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