Basic Information
| Provider Information | |||||||||
| NPI: | 1487192795 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CENTRAL IOWA HOSPITAL CORPORATION | ||||||||
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| OtherOrganizationName: | MIDWIFE SERVICES OF UNITYPOINT HEALTH | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3714 INGERSOLL AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503123411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153096011 | ||||||||
| FaxNumber: | 5153096014 | ||||||||
| Practice Location | |||||||||
| Address1: | 3714 INGERSOLL AVE | ||||||||
| Address2: | |||||||||
| City: | DES MOINES | ||||||||
| State: | IA | ||||||||
| PostalCode: | 503123411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5153096011 | ||||||||
| FaxNumber: | 5153096014 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2017 | ||||||||
| LastUpdateDate: | 02/07/2017 | ||||||||
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| AuthorizedOfficialLastName: | CORFITS | ||||||||
| AuthorizedOfficialFirstName: | JOSEPH | ||||||||
| AuthorizedOfficialMiddleName: | F. | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5152416507 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP1700X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Perinatal | 367A00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.