Healthcare Provider Details
I. General information
NPI: 1003908666
Provider Name (Legal Business Name): CENTRAL IOWA HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/29/2006
Last Update Date: 09/22/2023
Certification Date: 09/22/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1200 PLEASANT ST
DES MOINES IA
50309-1406
US
IV. Provider business mailing address
PO BOX 843151
KANSAS CITY MO
64184-3151
US
V. Phone/Fax
- Phone: 515-241-6212
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 341600000X |
| Taxonomy | Ambulance |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 273Y00000X |
| Taxonomy | Rehabilitation Hospital Unit |
| License Number | 77T082 |
| License Number State | IA |
VIII. Authorized Official
Name:
THOMAS
MATHEWS
Title or Position: CFO
Credential:
Phone: 515-241-6507