# PACIFICA HEALTH SERVICES LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pacifica Outpatient
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487881397
- **Authorized official:** ALLEN PHILIP WOLNERMAN RPH, FASCP (OWNER)
- **Authorized official phone:** (515) 285-2559

## Contact information

- **Practice address:** 4911 SW 19TH ST, DES MOINES, IA 50315-4487
- **Practice address phone:** (515) 285-2559
- **Practice address fax:** (515) 285-6487
- **Mailing address:** 4911 SW 19TH ST, DES MOINES, IA 50315-4487
- **Mailing address phone:** (515) 285-2559
- **Mailing address fax:** (515) 285-6487

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QH0700X | Hearing and Speech Clinic/Center | 770692 | IA | — |
| 261QP2000X | Physical Therapy Clinic/Center | 770692 | IA | Yes |
| 261QX0100X | Occupational Medicine Clinic/Center | 770692 | IA | — |

## Other

- **Enumeration date:** 06/18/2009
- **Last updated:** 06/18/2009