Provider Demographics
NPI:1043419070
Name:IOWA VETERANS HOME
Entity Type:Organization
Organization Name:IOWA VETERANS HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY BUREAU CHIEF
Authorized Official - Prefix:
Authorized Official - First Name:LAICY
Authorized Official - Middle Name:L
Authorized Official - Last Name:MAROTTI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:641-753-4424
Mailing Address - Street 1:1301 SUMMIT STREET
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158
Mailing Address - Country:US
Mailing Address - Phone:641-753-4424
Mailing Address - Fax:641-753-4290
Practice Address - Street 1:1301 SUMMIT STREET
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158
Practice Address - Country:US
Practice Address - Phone:641-753-4424
Practice Address - Fax:641-753-4290
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA5181835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatricGroup - Single Specialty