Provider Demographics
NPI:1164611265
Name:VNA HOSPICE OF SOUTHWEST IOWA
Entity Type:Organization
Organization Name:VNA HOSPICE OF SOUTHWEST IOWA
Other - Org Name:HSI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:ULFERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-930-4166
Mailing Address - Street 1:822 S MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0901
Mailing Address - Country:US
Mailing Address - Phone:712-352-1389
Mailing Address - Fax:712-352-2070
Practice Address - Street 1:822 S MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0901
Practice Address - Country:US
Practice Address - Phone:712-352-1389
Practice Address - Fax:712-352-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2021-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA161576251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
161576Medicare Oscar/Certification
IA161576Medicare PIN