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General NPI Number Information
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NPI Number | 1437628468
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Entity Type | Organization
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Legal Business Name | IOWA TOTAL CARE, INC
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Dates
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Enumeration Date | 11/20/2018
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Last Update Date | 11/20/2018
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Provider Practice Location Address
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Address Line | 1080 JORDAN CREEK PARKWAY
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City | WEST DES MONIES
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State | IA
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Zip | 58026
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Country | US
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Telephone | 314-725-4477
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Fax |
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Provider Business Mailing Address
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Address Line | 7700 FORSYTH BLVD STE 800
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City | CLAYTON
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State | MO
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Zip | 63105-1849
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT, MEDICAID SOLUTIONS
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Name | CHRISTOPHER PRIEST
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Credential |
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Telephone | 314-302-2859
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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