Provider Demographics
NPI:1962447250
Name:IOWA CITY HOSPICE, INC.
Entity Type:Organization
Organization Name:IOWA CITY HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-356-5665
Mailing Address - Street 1:1526 SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-6021
Mailing Address - Country:US
Mailing Address - Phone:319-351-5665
Mailing Address - Fax:319-351-5729
Practice Address - Street 1:1526 SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-6021
Practice Address - Country:US
Practice Address - Phone:319-351-5665
Practice Address - Fax:319-351-5729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA61507OtherWELLMARK BCBS OF IOWA
IA0615070Medicaid
IA0615070Medicaid