Healthcare Provider Details

I. General information

NPI: 1841039856
Provider Name (Legal Business Name): CATHOLIC HEALTH INITIATIVES-IOWA CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 10/21/2024
Certification Date: 10/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N 4TH AVE E STE 131
NEWTON IA
50208-3135
US

IV. Provider business mailing address

PO BOX 677080
DALLAS TX
75267-7080
US

V. Phone/Fax

Practice location:
  • Phone: 641-787-5444
  • Fax: 641-787-3038
Mailing address:
  • Phone: 641-787-5444
  • Fax: 641-787-3038

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KURT ANDERSEN
Title or Position: PRESIDENT
Credential:
Phone: 515-358-9200