Organization
INFINITY HEALTH - ARCHIVED
Active
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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