MEDICARE: PRIMARY HEALTH CARE, INC.

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	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1598204182
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRIMARY HEALTH CARE, INC.

Provider Business Mailing Address
First Line	:	1200 UNIVERSITY AVE STE 200
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50314-2355
Country	:	US
Telephone Number	:	515-248-1447
Fax Number	:	515-248-1440

Provider Business Practice Location Address
First Line	:	4800 AURORA AVE
Second Line	:
City	:	DES MOINES
State	:	IA
Zip	:	50310-2903
Country	:	US
Telephone Number	:	515-242-7300
Fax Number	:	515-248-1510

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	NATHANIEL A SIMPSON
Credential	:
Telephone Number	:	515-248-1441

Provider Enumeration Date	:	02/16/2017
Last Update Date	:	01/07/2026

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