Provider Demographics
NPI:1568599314
Name:CENTRAL IOWA HOSPITAL CORP.
Entity Type:Organization
Organization Name:CENTRAL IOWA HOSPITAL CORP.
Other - Org Name:BLANK HEALTH PROVIDERS NP GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BECKY
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTON-QUIGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:CAPPM, MCPM
Authorized Official - Phone:515-241-6447
Mailing Address - Street 1:1212 PLEASANT ST.
Mailing Address - Street 2:STE. 300
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1453
Mailing Address - Country:US
Mailing Address - Phone:515-241-5926
Mailing Address - Fax:515-241-5127
Practice Address - Street 1:1212 PLEASANT ST.
Practice Address - Street 2:STE. 300
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1453
Practice Address - Country:US
Practice Address - Phone:515-241-5926
Practice Address - Fax:515-241-5127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA073850Medicaid
IA0738500Medicaid
IA073850Medicaid