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Organization

INFINITY HEALTH - ARCHIVED

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMANTHA CANNON (CEO)
(641) 446-2383
Entity
Organization

Contact information

Practice address
802 ACKERLEY ST, LAMONI, IA 50140-1544
(641) 784-7911
(641) 784-6162
Mailing address
302 NE 14TH ST, LEON, IA 50144-1206
(641) 446-2383
(641) 446-2382

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
IA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0462861
IA
01
39015
WELLMARK BLUE CROSS/BLUE SHIELD
05
507202208
MO
01
61827
WELLMARK MEDICARE BLUE PPO
IA
Enumeration date
04/17/2007
Last updated
02/11/2022
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