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Organization
BROADLAWNS MEDICAL CENTER
Active
Organization
BROADLAWNS MEDICAL CENTER
Active
Other names
Broadlawns Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
VINCENT J MANDRACCHIA DPM (CHIEF MEDICAL OFFICER)
(515) 282-2562
Entity
Organization
Contact information
Practice address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
(515) 282-7823
Mailing address
1801 HICKMAN RD, DES MOINES, IA 50314-1505
(515) 282-2200
(515) 282-7823
Taxonomy
Speciality
Code
Description
License number
State
273R00000X
Psychiatric Hospital Unit
770032H
IA
282N00000X
General Acute Care Hospital
Primary
770032H
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0236471
—
IA
05
—
0265959
—
IA
05
—
0427476
—
IA
05
—
0432567
—
IA
05
—
0601013
—
IA
01
—
100020
AMERICAN PYSCH SYSTMES
IA
01
—
132198
VALUE OPTIONS
IA
01
—
20023
TRICARE
IA
01
—
2601013
HOSPITAL IOWA CARE NUMBER
IA
01
—
26595
WELLMARK PROF ED
IA
01
—
28545
WELLMARK PROF CLINIC
IA
01
—
29705
CONVENTRY HEALTHCARE
IA
01
—
60101
WELLMARK INSTITUTIONAL
IA
01
—
6230290
AETNA
IA
01
—
6S101
WELLMARK INST PSYCH
IA
01
—
A5031401
JOHN DEERE, UHC RIVER VAL
IA
Enumeration date
09/14/2005
Last updated
05/13/2015
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