Provider Demographics
NPI:1538392451
Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Entity type:Organization
Organization Name:CATHOLIC HEALTH INITIATIVES IOWA CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES/CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:VELLINGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-247-4278
Mailing Address - Street 1:PO BOX 8365
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50301-8365
Mailing Address - Country:US
Mailing Address - Phone:515-282-6902
Mailing Address - Fax:515-282-2911
Practice Address - Street 1:1449 NW 128TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-7425
Practice Address - Country:US
Practice Address - Phone:515-358-9750
Practice Address - Fax:515-358-9760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-26
Last Update Date:2011-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0815810008Medicare NSC