Organization
CEDAR VALLEY MEDICAL SPECIALISTS PC
Active
Parent organization
CEDAR VALLEY MEDICAL SPECIALISTS PC
Other names
West Union Dialysis Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CEDAR VALLEY MEDICAL SPECIALISTS PC
Authorized official
GILMORE JOHN IREY (CEO)
(319) 235-5390
Entity
Organization
Contact information
Practice address
405 HIGHWAY 150 N, WEST UNION, IA 52175-1003
(563) 422-5734
(563) 422-5830
Mailing address
PO BOX 2758, WATERLOO, IA 50704-2758
(563) 422-5734
(563) 422-5830
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0625269
—
IA
01
—
62526
WELLMARK
IA
Enumeration date
05/20/2006
Last updated
04/20/2008
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