Healthcare Provider Details

I. General information

NPI: 1497756373
Provider Name (Legal Business Name): UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2949 SIERRA CT SW
IOWA CITY IA
52240-8503
US

IV. Provider business mailing address

2949 SIERRA CT SW
IOWA CITY IA
52240-8503
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-8522
  • Fax: 319-337-8524
Mailing address:
  • Phone: 319-337-8522
  • Fax: 319-337-8524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number1068
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number1068
License Number StateIA

VIII. Authorized Official

Name: DR. SHANE THOMAS SEDENKA
Title or Position: EXECUTIVE DIRECTOR
Credential: PHARMD.
Phone: 319-688-6951