Provider Demographics
NPI:1477984367
Name:CATHOLIC HEALTH INITIATIVES, IA-CORP
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES, IA-CORP
Other - Org Name:MERCY MEDICAL MAMMOGRAPHY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:RITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-247-4273
Mailing Address - Street 1:PO BOX 14584
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-3584
Mailing Address - Country:US
Mailing Address - Phone:515-247-3045
Mailing Address - Fax:
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 1265
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-247-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA261QR0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, Mammography