Provider Demographics
NPI:1023551819
Name:UNITYPOINT AT HOME
Entity Type:Organization
Organization Name:UNITYPOINT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-557-3236
Mailing Address - Street 1:1776 W LAKES PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8378
Mailing Address - Country:US
Mailing Address - Phone:515-557-3100
Mailing Address - Fax:
Practice Address - Street 1:11333 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7908
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:515-557-3186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITYPOINT AT HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-28
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA113336C0003X, 3336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5360980001Medicare NSC