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General NPI Number Information
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NPI Number | 1669347928
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Entity Type | Organization
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Legal Business Name | SOUTHWEST IOWA HEALTH VENTURES PLLC
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Dates
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Enumeration Date | 10/07/2025
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Last Update Date | 06/10/2026
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Provider Practice Location Address
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Address Line | 1221 E PIERCE ST STE 100
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4714
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Country | US
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Telephone | 402-671-2644
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Fax | 402-387-7531
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Provider Business Mailing Address
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Address Line | 2255 S 132ND ST STE 100
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City | OMAHA
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State | NE
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Zip | 68144-2573
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Country | US
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Telephone | 402-671-2644
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Fax | 402-387-7531
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Authorized Official
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Title or Position | CEO
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Name | GABRIEL MICHAEL SULLIVAN
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Credential |
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Telephone | 402-671-2644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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