Provider Demographics
NPI:1831344944
Name:IOWA HOPSICE, LLC
Entity type:Organization
Organization Name:IOWA HOPSICE, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MORELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-276-6696
Mailing Address - Street 1:5650 NW JOHNSTON DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1375
Mailing Address - Country:US
Mailing Address - Phone:515-276-6696
Mailing Address - Fax:515-276-1915
Practice Address - Street 1:800 1ST AVE NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-5006
Practice Address - Country:US
Practice Address - Phone:515-276-6696
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-18
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA161578Medicare Oscar/Certification