Healthcare Provider Details

I. General information

NPI: 1770521981
Provider Name (Legal Business Name): INFINITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 02/11/2022
Certification Date: 02/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 NE 14TH ST
LEON IA
50144-1206
US

IV. Provider business mailing address

302 NE 14TH ST
LEON IA
50144-1206
US

V. Phone/Fax

Practice location:
  • Phone: 641-446-2383
  • Fax: 641-446-2383
Mailing address:
  • Phone: 641-446-2383
  • Fax: 641-446-2382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MS. SAMANTHA CANNON
Title or Position: CEO
Credential:
Phone: 641-446-2383