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General NPI Number Information
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NPI Number | 1386535771
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Entity Type | Organization
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Legal Business Name | STATE UNIVERSITY OF IOWA
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Dates
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Enumeration Date | 07/14/2025
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 2901 86TH ST STE 200
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City | URBANDALE
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State | IA
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Zip | 50322-4330
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Country | US
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Telephone | 555-102-0721
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Fax | 515-666-4500
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Provider Business Mailing Address
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Address Line | 2901 86TH ST
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City | URBANDALE
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State | IA
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Zip | 50322-4330
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Country | US
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Telephone | 555-102-0721
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Fax | 515-666-4500
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Authorized Official
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Title or Position | SR DIRECTOR OF GOVERNMENT REIMB
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Name | MR. JOE M MCKELVEY JR.
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Credential |
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Telephone | 319-467-8549
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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