Organization
COVENANT MEDICAL CENTER INC
Active
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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