Provider Demographics
NPI:1013942788
Name:UNITYPOINT AT HOME
Entity Type:Organization
Organization Name:UNITYPOINT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-557-3236
Mailing Address - Street 1:1776 W LAKES PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8378
Mailing Address - Country:US
Mailing Address - Phone:515-557-3100
Mailing Address - Fax:
Practice Address - Street 1:11333 AURORA AVE
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-7908
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:515-557-3186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITYPOINT AT HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-11
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251F00000X, 333600000X, 3336C0003X
IA113336H0001X
IL054-0140283336H0001X
SD400-02983336H0001X
NE1573336H0001X
MO20150281283336H0001X
WI258433336H0001X
MN2651723336H0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No251F00000XAgenciesHome Infusion
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600026832Medicaid
IA0449843Medicaid
SD8533960Medicaid
WI100036451Medicaid
NE10025347900Medicaid
SD8533960Medicaid