Healthcare Provider Details

I. General information

NPI: 1659510212
Provider Name (Legal Business Name): IOWA HOSPICE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 05/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5650 NW JOHNSTON DR STE E
JOHNSTON IA
50131-1375
US

IV. Provider business mailing address

5650 NW JOHNSTON DR STE E
JOHNSTON IA
50131-1375
US

V. Phone/Fax

Practice location:
  • Phone: 515-276-6696
  • Fax: 817-731-3529
Mailing address:
  • Phone: 515-276-6696
  • Fax: 817-731-3529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW POSEY
Title or Position: CFO
Credential:
Phone: 817-551-0355