Provider Demographics
NPI:1538109889
Name:PLANNED PARENTHOOD OF THE HEARTLAN
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF THE HEARTLAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:DRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-698-2406
Mailing Address - Street 1:671 VANDALIA ST
Mailing Address - Street 2:ATTN: PPH
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1312
Mailing Address - Country:US
Mailing Address - Phone:866-290-4325
Mailing Address - Fax:515-280-9525
Practice Address - Street 1:850 ORCHARD ST
Practice Address - Street 2:PLANNED PARENTHOOD OF THE HEARTLAND
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-5412
Practice Address - Country:US
Practice Address - Phone:319-354-2249
Practice Address - Fax:319-354-4504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA000713207Q00000X, 363A00000X
IA01898207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0057570Medicaid
IAGROUP 0057570Medicaid
IA0057570Medicaid
IAA02049Medicare UPIN
IAGROUP 0057570Medicaid
IAP29488Medicare PIN