Organization
JEROME R. GREENBERG, O.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME RICHARD GREENBERG O.D. (PRESIDENT)
(515) 263-0295
Entity
Organization
Contact information
Practice address
1242 E 14TH ST, DES MOINES, IA 50316-2402
(515) 263-0295
(515) 263-0115
Mailing address
1242 E 14TH ST, DES MOINES, IA 50316-2402
(515) 263-0295
(515) 263-0115
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
01709
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000
TRIWEST
IA
05
—
0005314
—
IA
01
—
17996
FIRST ADMINISTRATORS
IA
01
—
410020694
RAILROAD MEDICARE
IA
01
—
6155
MIDLANDS CHOICE
IA
01
—
81376
COVENTRY HEALTHCARE
IA
01
—
IA0101
UNITED HEALTHCARE OF THE RIVER VALLEY
IA
Enumeration date
08/08/2008
Last updated
10/27/2008
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