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General NPI Number Information
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NPI Number | 1750569711
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Entity Type | Organization
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Legal Business Name | CENTRAL IOWA HOSPITAL CORPORATION
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Dates
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Enumeration Date | 02/01/2008
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Last Update Date | 02/01/2008
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Provider Practice Location Address
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Address Line | 1221 PLEASANT ST SUITE A100
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City | DES MOINES
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State | IA
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Zip | 50309-1423
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Country | US
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Telephone | 515-241-3394
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Fax | 515-241-8910
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Provider Business Mailing Address
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Address Line | 1221 PLEASANT ST SUITE A100
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City | DES MOINES
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State | IA
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Zip | 50309-1423
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Country | US
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Telephone | 515-241-3394
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Fax | 515-241-8910
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Authorized Official
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Title or Position | OUTPATIENT SERVICE MANAGER
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Name | MR. KEVIN DERONDE
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Credential | MBA, ACHE
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Telephone | 515-241-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number |
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License Number State |
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