Provider Demographics
NPI:1437628468
Name:IOWA TOTAL CARE, INC
Entity type:Organization
Organization Name:IOWA TOTAL CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, MEDICAID SOLUTIONS
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:PRIEST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-302-2859
Mailing Address - Street 1:7700 FORSYTH BLVD STE 800
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1080 JORDAN CREEK PARKWAY
Practice Address - Street 2:
Practice Address - City:WEST DES MONIES
Practice Address - State:IA
Practice Address - Zip Code:58026
Practice Address - Country:US
Practice Address - Phone:314-725-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO302R0000XOtherTAXONOMY CODE