Provider Demographics
NPI:1497756373
Name:UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC
Entity Type:Organization
Organization Name:UNIVERSITY OF IOWA COMMUNITY MEDICAL SERVICES, LLC
Other - Org Name:UI COMMUNITY HOMECARE-IV INFUSION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:SEDENKA
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:319-688-6951
Mailing Address - Street 1:2949 SIERRA CT SW
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-8503
Mailing Address - Country:US
Mailing Address - Phone:319-337-8522
Mailing Address - Fax:319-337-8524
Practice Address - Street 1:2949 SIERRA CT SW
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-8503
Practice Address - Country:US
Practice Address - Phone:319-337-8522
Practice Address - Fax:319-337-8524
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-02
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1068251F00000X, 3336H0001X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0709183Medicaid
IA0709184Medicaid
IA56534OtherBCBS INFUSION