Organization
CENTRAL IOWA HOSPITAL CORPORATION
Active
Parent organization
CENTRAL IOWA HOSPITAL CORPORATION
Other names
East Des Moines Family Care Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CENTRAL IOWA HOSPITAL CORPORATION
Authorized official
MICHAEL J DEWERFF (CFO)
(515) 241-6507
Entity
Organization
Contact information
Practice address
840 E UNIVERSITY AVE, DES MOINES, IA 50316-2304
(515) 265-4211
(515) 309-5993
Mailing address
5409 NW 88TH ST, SUITE 200, JOHNSTON, IA 50131-2949
(515) 362-5980
(515) 362-5985
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
2085R0001X
Radiation Oncology Physician
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0096958
—
IA
01
—
CC7397
RAILROAD MEDICARE GROUP
IA
Enumeration date
05/18/2006
Last updated
03/19/2019
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