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General NPI Number Information
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NPI Number | 1932904927
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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 | 02/14/2025
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 2100 ACT CIR STE 100
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City | IOWA CITY
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State | IA
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Zip | 52245-9581
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Country | US
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Telephone | 319-353-9668
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Fax | 319-353-8443
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Provider Business Mailing Address
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Address Line | 2100 ACT CIR STE 100
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City | IOWA CITY
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State | IA
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Zip | 52245-9581
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Country | US
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Telephone | 319-353-9668
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Fax | 319-353-8443
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Authorized Official
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Title or Position | SR DIR OF GOV'T 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 | 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 | 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 #3
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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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