MEDICARE: CATHOLIC HEALTH INITIATIVES-IOWA CORP

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	3336C0002X	Clinic Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	1193	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2030148	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1619952926
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CATHOLIC HEALTH INITIATIVES-IOWA CORP

Provider Business Mailing Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 234
City	:	CLIVE
State	:	IA
Zip	:	50325-7007
Country	:	US
Telephone Number	:	515-222-7979
Fax Number	:	515-222-7976

Provider Business Practice Location Address
First Line	:	1601 NW 114TH ST
Second Line	:	SUITE 234
City	:	CLIVE
State	:	IA
Zip	:	50325-7007
Country	:	US
Telephone Number	:	515-222-7979
Fax Number	:	515-222-7976

Authorized Official
Title or Position	:	PRESIDENT
Name	:	KURT ANDERSEN
Credential	:
Telephone Number	:	515-358-9200

Provider Enumeration Date	:	12/08/2005
Last Update Date	:	10/21/2024

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Directions to “CATHOLIC HEALTH INITIATIVES-IOWA CORP ” Practice Location

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