Provider Demographics
NPI:1871658948
Name:CATHOLIC HEALTH INITIATIVES-IOWA CORP
Entity Type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES-IOWA CORP
Other - Org Name:MERCYONE ANKENY IMAGING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INTERIM PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WEGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-247-4278
Mailing Address - Street 1:PO BOX 802
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50304-0802
Mailing Address - Country:US
Mailing Address - Phone:515-643-7676
Mailing Address - Fax:
Practice Address - Street 1:800 E 1ST ST
Practice Address - Street 2:SUITE 1100
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50021-2077
Practice Address - Country:US
Practice Address - Phone:515-643-7676
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA38870OtherWELLMARK BLUE CROSS
IA0458067Medicaid
IA0458067Medicaid