Provider Demographics
NPI:1649477795
Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Entity type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF BILLING
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-643-8727
Mailing Address - Street 1:603 E 12TH ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-5515
Mailing Address - Country:US
Mailing Address - Phone:515-643-0131
Mailing Address - Fax:
Practice Address - Street 1:603 E 12TH ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-5515
Practice Address - Country:US
Practice Address - Phone:515-643-0131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERCY MEDICAL CENTER OF DES MOINES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-02
Last Update Date:2009-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0110882Medicaid
IA67133OtherWELLMARK BLUE CROSS OF IO