Provider Demographics
NPI:1235676412
Name:CENTRAL IOWA HOSPITAL CORPORATION
Entity Type:Organization
Organization Name:CENTRAL IOWA HOSPITAL CORPORATION
Other - Org Name:UPHDM REHABILITATION PHYSICIANS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEWERFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-241-6507
Mailing Address - Street 1:1200 PLEASANT ST
Mailing Address - Street 2:ROOM SOUTH 236
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1406
Mailing Address - Country:US
Mailing Address - Phone:515-241-6228
Mailing Address - Fax:515-241-8685
Practice Address - Street 1:1200 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1406
Practice Address - Country:US
Practice Address - Phone:515-241-6435
Practice Address - Fax:515-241-8010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-25
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No364SR0400XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistRehabilitationGroup - Multi-Specialty