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2515 Cyclone Dr, Waterloo, IA 50701-9746 | |
(319) 433-3000 | |
(319) 232-1155 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 2515 Cyclone Dr, Waterloo, Iowa |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1285618496 | NPI | - | NPPES |
0427898 | Medicaid | IA | |
CE7549 | Other | IA | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 02050 (Iowa) | Secondary |
207W00000X | Ophthalmology | 24873 (Iowa) | Primary |
Provider Name | Richard C Mauer |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1417939067 PECOS PAC ID: 3577455369 Enrollment ID: I20040331000791 |
Provider Name | Amy L Hartmann |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508848151 PECOS PAC ID: 7012043185 Enrollment ID: I20100327000537 |
Mailing Address | Practice Location Address |
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2515 Cyclone Dr, Waterloo, IA 50701-9746 Ph: (319) 433-3000 | 2515 Cyclone Dr, Waterloo, IA 50701-9746 Ph: (319) 433-3000 |