1972656841 NPI number — CITY OF DES MOINES IOWA

Table of content: (NPI 1972656841)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972656841 NPI number — CITY OF DES MOINES IOWA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CITY OF DES MOINES IOWA
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:
Provider Other Organization Name Type Code:
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:
1972656841
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 511
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
833-810-5003
Provider Business Mailing Address Fax Number:
515-237-1670

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 ROBERT D RAY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-283-4093
Provider Business Practice Location Address Fax Number:
515-237-1670
Provider Enumeration Date:
01/22/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SCHAUL
Authorized Official First Name:
NICKOLAS
Authorized Official Middle Name:
Authorized Official Title or Position:
FINANCE DIRECTOR
Authorized Official Telephone Number:
515-283-4540

Provider Taxonomy Codes

  • Taxonomy code: 3416L0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0095265 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 09526 . This is a "WELLMARK BC BS NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 285478300 . This is a "US DEPT OF LABOR NUMBER" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".