MEDICARE: IOWA CITY HOSPICE, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1538795943
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IOWA CITY HOSPICE, INC.

Provider Business Mailing Address
First Line	:	1025 WADE ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6626
Country	:	US
Telephone Number	:	319-688-4200
Fax Number	:	319-351-5729

Provider Business Practice Location Address
First Line	:	1526 SYCAMORE ST
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-6021
Country	:	US
Telephone Number	:	319-351-5665
Fax Number	:	319-351-5729

Authorized Official
Title or Position	:	DIRECTOR OF FINANCE
Name	:	KAREN DEGROOT
Credential	:
Telephone Number	:	319-351-5665

Provider Enumeration Date	:	03/17/2020
Last Update Date	:	11/29/2023

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