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General NPI Number Information
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NPI Number | 1508858127
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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 | 08/19/2005
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 200 HAWKINS DR CC101 GH
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-2577
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Fax | 319-467-5145
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Provider Business Mailing Address
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Address Line | 200 HAWKINS DR CC101 GH
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City | IOWA CITY
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State | IA
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Zip | 52242-1009
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Country | US
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Telephone | 319-356-2577
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Fax | 319-467-5145
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Authorized Official
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Title or Position | SR DIR OF GOVT REIMBURSEMENT
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Name | JOE M MCKELVEY
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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 | 3336S0011X
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Taxonomy Name | Specialty 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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 599
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License Number State | IA
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