Healthcare Provider Details

I. General information

NPI: 1578514162
Provider Name (Legal Business Name): CENTRAL IOWA HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2901 86TH ST
URBANDALE IA
50322-4201
US

IV. Provider business mailing address

5409 NW 88TH ST SUITE 200
JOHNSTON IA
50131-2949
US

V. Phone/Fax

Practice location:
  • Phone: 515-276-3406
  • Fax: 515-276-5141
Mailing address:
  • Phone: 515-362-5980
  • Fax: 515-362-5985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH F. CORFITS JR.
Title or Position: CFO
Credential:
Phone: 515-241-6507