Provider Demographics
NPI:1629299672
Name:PENTACREST, INC.
Entity Type:Organization
Organization Name:PENTACREST, INC.
Other - Org Name:PATHWAYS
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER BILLING
Authorized Official - Prefix:
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BATCHELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-743-9529
Mailing Address - Street 1:800 1ST ST NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52405-2713
Mailing Address - Country:US
Mailing Address - Phone:319-398-3644
Mailing Address - Fax:319-398-3937
Practice Address - Street 1:817 PEPPERWOOD LN
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-7005
Practice Address - Country:US
Practice Address - Phone:319-339-6162
Practice Address - Fax:319-339-6164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0746644Medicaid