Organization
COVENANT MEDICAL CENTER INC
Active
Other names
MercyOne Waterloo Home Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY HUBER (CFO)
(319) 272-7607
Entity
Organization
Contact information
Practice address
441 E SAN MARNAN DR, WATERLOO, IA 50702-5900
(319) 272-7600
(319) 272-7597
Mailing address
PO BOX 6280, WATERLOO, IA 50704-6280
(319) 272-7600
(319) 272-7597
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
335E00000X
Prosthetic/Orthotic Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-07-039593 2
HOUSEHOLD HAXARDOUS MATERIAL RETAILER
IA
01
—
6217
WHOLE DRUG LICENSE
IA
Enumeration date
05/05/2011
Last updated
10/10/2024
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