Organization
GENGASTRO LLC
Active
Other names
Endoscopy Center for Digestive Health
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAIGE TAGUE (LEAD INSURANCE BILLER)
(563) 383-2686
Entity
Organization
Contact information
Practice address
2222 53RD AVE, BETTENDORF, IA 52722-7546
(563) 383-2686
(563) 884-8144
Mailing address
2222 53RD AVE, BETTENDORF, IA 52722-7546
(563) 383-2686
(563) 884-8144
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
IA
261QE0800X
Endoscopy Clinic/Center
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0610279
—
IA
01
—
1603165
CSA
IA
Enumeration date
11/30/2005
Last updated
03/07/2023
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