Provider Demographics
NPI: | 1033532718 |
---|---|
Name: | CATHOLIC HEALTH INITIATIVES-IOWA CORP |
Entity Type: | Organization |
Organization Name: | CATHOLIC HEALTH INITIATIVES-IOWA CORP |
Other - Org Name: | MERCY ONE-KNOXVILLE |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RITZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 515-247-4273 |
Mailing Address - Street 1: | PO BOX 677080 |
Mailing Address - Street 2: | |
Mailing Address - City: | DALLAS |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 75267-7080 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 515-226-7937 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1545 HIGHWAY 14 |
Practice Address - Street 2: | |
Practice Address - City: | KNOXVILLE |
Practice Address - State: | IA |
Practice Address - Zip Code: | 50138-8600 |
Practice Address - Country: | US |
Practice Address - Phone: | 515-643-2640 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2014-01-30 |
Last Update Date: | 2014-06-25 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IA | 8770200 | 3416A0800X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3416A0800X | Transportation Services | Ambulance | Air Transport |