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Organization

IOWA EYE PROSTHETICS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DAVID MICHAEL BULGARELLI BA, BCO, FASO (PRESIDENT, OCULARIST)
(319) 354-3434
Entity
Organization

Contact information

Practice address
625 1ST AVE, SUITE 200, CORALVILLE, IA 52241-2101
(319) 354-3434
Mailing address
625 1ST AVE, SUITE 200, CORALVILLE, IA 52241-2101
(319) 354-3434

Taxonomy

Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
Primary
081105-08 CERT#
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0128413
IA
01
12841
BC-BS DME
IA
01
40219IO
BC-BS OF MN
IA
01
50796
BC-BS O & P
IA
01
63648
BC-BS OF KS
IA
01
A001983
CHAMPUS
IA
Enumeration date
01/04/2007
Last updated
08/22/2020
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