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Contact Information

STATE UNIVERSITY OF IOWA
3056 RIVER CROSSING COURT
STE A
RIVERSIDE, IA52327
 Phone: 319-467-8383
 Fax: 319-467-8378
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STATE UNIVERSITY OF IOWA

NPI Number 1174845101
LBN Legal business name STATE UNIVERSITY OF IOWA
Authorized official JAY JACKSON - (VICE PRESIDENT FOR MEDICAL AFFAIRS)
Entity Organization
Organization subpart 1 No
Enumeration date 02/18/2010
Last updated 09/06/2018 - About 8 years ago
Identifiers
IA License # 1370
IA License # 18469
IA Medicaid 0402616
Other 1623772 NCPDP PROVIDER IDENTIFICATION NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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