Healthcare Provider Details

I. General information

NPI: 1417094541
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES IOWA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 6TH AVE WEST 1
DES MOINES IA
50314-2613
US

IV. Provider business mailing address

PO BOX 14584
DES MOINES IA
50306-3584
US

V. Phone/Fax

Practice location:
  • Phone: 515-643-0850
  • Fax:
Mailing address:
  • Phone: 515-247-8133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: REBECCA LENZ
Title or Position: DIRECTOR OF CENTRAL BILLING OFFICE
Credential:
Phone: 515-643-8727