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NPI Code Detail

MEDICARE: STATE UNIVERSITY OF IOWA

MEDICARE: STATE UNIVERSITY OF IOWA
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
1261QE0700XEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
262306OTHERIAWELLMARK BCBS

General Provider Information

NPI Number : 1629054846
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATE UNIVERSITY OF IOWA
Provider Business Mailing Address
First Line : 200 HAWKINS DR
Second Line :
City : IOWA CITY
State : IA
Zip : 52242-1009
Country : US
Telephone Number : 319-356-1616
Fax Number :
Provider Business Practice Location Address
First Line : 5 LIONS DR
Second Line :
City : NORTH LIBERTY
State : IA
Zip : 52317-9575
Country : US
Telephone Number : 319-467-7190
Fax Number :
Authorized Official
Title or Position : SR DIRECTOR OF GOVERNMENT REIMB
Name : MR. JOE M MCKELVEY JR.
Credential :
Telephone Number : 319-467-8549
Provider Enumeration Date : 12/20/2005
Last Update Date : 04/24/2024

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Directions to “STATE UNIVERSITY OF IOWA ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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