MEDICARE: CENTRAL IOWA HOME CARE

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1790221968
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL IOWA HOME CARE

Provider Business Mailing Address
First Line	:	7012 MADISON AVE STE C
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-2664
Country	:	US
Telephone Number	:	515-276-0196
Fax Number	:

Provider Business Practice Location Address
First Line	:	7012 MADISON AVE STE C
Second Line	:
City	:	URBANDALE
State	:	IA
Zip	:	50322-2664
Country	:	US
Telephone Number	:	515-276-0196
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ANNE DAVENPORT
Credential	:
Telephone Number	:	515-276-0196

Provider Enumeration Date	:	01/12/2017
Last Update Date	:	01/12/2017

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