Healthcare Provider Details

I. General information

NPI: 1235676412
Provider Name (Legal Business Name): CENTRAL IOWA HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2017
Last Update Date: 03/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

1200 PLEASANT ST ROOM SOUTH 236
DES MOINES IA
50309-1406
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-6435
  • Fax: 515-241-8010
Mailing address:
  • Phone: 515-241-6228
  • Fax: 515-241-8685

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SR0400X
TaxonomyRehabilitation Clinical Nurse Specialist
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL J DEWERFF
Title or Position: CFO
Credential:
Phone: 515-241-6507