Organization
STATE UNIVERSITY OF IOWA
Active
Organization
STATE UNIVERSITY OF IOWA
Active
Other names
CHSC Ped Screening Center
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP E ROUDABUSH (DIRECTOR, PATIENT FINANCIAL SERVICE)
(319) 384-2334
Entity
Organization
Contact information
Practice address
3501 HARRY LANGDON BLVD STE 1450, CHILD HEALTH SPECIALTY CLINICS, COUNCIL BLUFFS, IA 51503-7837
(712) 309-0041
(712) 309-0044
Mailing address
100 HAWKINS DRIVE, CHILD HEALTH SPECIALTY CLINICS, IOWA CITY, IA 52242
(319) 354-6674
(319) 356-3715
Taxonomy
Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0734871
—
IA
Enumeration date
02/05/2007
Last updated
03/01/2012
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