MEDICARE: UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251F00000X	Home Infusion Agency	1068	IA
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336H0001X	Home Infusion Therapy Pharmacy	1068	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56534	OTHER	IA	BCBS INFUSION
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497756373
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC

Provider Business Mailing Address
First Line	:	2949 SIERRA CT SW
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8503
Country	:	US
Telephone Number	:	319-337-8522
Fax Number	:	319-337-8524

Provider Business Practice Location Address
First Line	:	2949 SIERRA CT SW
Second Line	:
City	:	IOWA CITY
State	:	IA
Zip	:	52240-8503
Country	:	US
Telephone Number	:	319-337-8522
Fax Number	:	319-337-8524

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	DR. SHANE THOMAS SEDENKA
Credential	:	PHARMD.
Telephone Number	:	319-688-6951

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	07/12/2024

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Directions to “UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC ” Practice Location

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