Provider Demographics
NPI:1881699486
Name:HOSPICE OF CENTRAL IOWA
Entity type:Organization
Organization Name:HOSPICE OF CENTRAL IOWA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MAFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-333-4261
Mailing Address - Street 1:3000 EASTON BLVD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50317-3124
Mailing Address - Country:US
Mailing Address - Phone:515-274-3400
Mailing Address - Fax:515-274-1137
Practice Address - Street 1:3000 EASTON BLVD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50317
Practice Address - Country:US
Practice Address - Phone:515-274-3400
Practice Address - Fax:515-274-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-20
Last Update Date:2019-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA61500OtherWELLMARK BC/BS
IA0615005Medicaid
IA161500Medicare ID - Type Unspecified