1700837606 NPI number — CENTRAL IOWA HOSPITAL CORPORATION

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700837606 NPI number — CENTRAL IOWA HOSPITAL CORPORATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTRAL IOWA HOSPITAL CORPORATION
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
JOHNSTON FAMILY PHYSICIANS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1700837606
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5409 NW 88TH ST
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
JOHNSTON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50131-2949
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-362-5980
Provider Business Mailing Address Fax Number:
515-362-5985

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5900 NW 86TH ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
JOHNSTON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50131-2284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-276-6133
Provider Business Practice Location Address Fax Number:
515-334-7356
Provider Enumeration Date:
05/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CORFITS
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
515-241-6507

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0262121 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CK5160 . This is a "RAILROAD MEDICARE GROUP" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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