Organization
STATE UNIVERSITY OF IOWA
Active
Parent organization
STATE UNIVERSITY OF IOWA
Other names
University of Iowa Health Care Medical Center-Washington Dialysis Ctr, University of Iowa Hospitals & Clinics-Washington Dialysis Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE UNIVERSITY OF IOWA
Authorized official
MR. JOE M MCKELVEY JR. (SR DIRECTOR OF GOVERNMENT REIMB)
(319) 467-8549
Entity
Organization
Contact information
Practice address
414 E POLK ST, WASHINGTON, IA 52353-1237
(319) 653-4171
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 356-1616
Taxonomy
Speciality
Code
Description
License number
State
261QE0700X
End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0600585
—
IA
01
—
62306
WELLMARK BCBS
IA
Enumeration date
12/07/2005
Last updated
04/24/2024
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