NPI 1760916779

Mine

Organisation Health Maintenance Organization Des Moines, IA

Practice location

Address: 2 SW 9th St 316, Des Moines, IA 50309-4310
Phone: (515) 729-9350
Mailing address: 2 S.W. 9th Street 316, Des Moines, IA 50309-1234

Authorised official

Name: Robert Dean Forkner
Title: Myself
Phone: (515) 729-9350

Registered specialties

Health Maintenance Organization Primary

Managed Care Organizations Taxonomy 302R00000X Licence 483062595 (IA)

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Registry record

NPI: 1760916779
Entity type: Organization
NPI issued: 17 Apr 2017
Record last updated: 17 Apr 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.