Healthcare Provider Details
I. General information
NPI: 1053400960
Provider Name (Legal Business Name): UNITYPOINT AT HOME
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/11/2006
Last Update Date: 12/31/2024
Certification Date: 12/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
11333 AURORA AVE.
URBANDALE IA
50322
US
IV. Provider business mailing address
1776 W LAKES PKWY STE 400
WEST DES MOINES IA
50266-8378
US
V. Phone/Fax
- Phone: 515-557-3100
- Fax: 515-557-3186
- Phone: 515-557-3100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | 5055 |
| License Number State | IA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 400-0298 |
| License Number State | SD |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 157 |
| License Number State | NE |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 11 |
| License Number State | IA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 265172 |
| License Number State | MN |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 2015028128 |
| License Number State | MO |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | Y007085 |
| License Number State | AZ |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 258-43 |
| License Number State | WI |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3336H0001X |
| Taxonomy | Home Infusion Therapy Pharmacy |
| License Number | 54.015478 |
| License Number State | IL |
VIII. Authorized Official
Name:
MARISSA
A
SMITH
Title or Position: VP ACCREDITATION AND REG AFFAIRS
Credential:
Phone: 515-557-3100