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Organization

CATHOLIC HEALTH INITIATIVES-IOWA CORP

Active
Other names
Mercy Family Medicine Center
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID VELLINGA (PRES/CEO)
(515) 247-4278
Entity
Organization

Contact information

Practice address
250 LAUREL ST, DES MOINES, IA 50314-3024
(515) 643-4610
Mailing address
PO BOX 645, DES MOINES, IA 50303-0645
(515) 643-4610

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0160705
IA
01
40167
WELLMARK BLUE CROSS
IA
Enumeration date
12/29/2006
Last updated
11/28/2012
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