Organization
CATHOLIC HEALTH INITIATIVES-IOWA CORP
Active
Other names
MercyOne Clive Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KURT ANDERSEN (PRESIDENT)
(515) 358-9200
Entity
Organization
Contact information
Practice address
1601 NW 114TH ST, SUITE 234, CLIVE, IA 50325-7007
(515) 222-7979
(515) 222-7976
Mailing address
1601 NW 114TH ST, SUITE 234, CLIVE, IA 50325-7007
(515) 222-7979
(515) 222-7976
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1193
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0269373
—
IA
01
—
2030148
PK
—
Enumeration date
12/08/2005
Last updated
10/21/2024
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