Provider Demographics
NPI:1053406215
Name:UNITYPOINT AT HOME
Entity type:Organization
Organization Name:UNITYPOINT AT HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP/CHIEF COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARISSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-557-3100
Mailing Address - Street 1:1776 W LAKES PKWY STE 400
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-8378
Mailing Address - Country:US
Mailing Address - Phone:515-557-3100
Mailing Address - Fax:
Practice Address - Street 1:12695 UNIVERSITY AVE
Practice Address - Street 2:SUITE 120
Practice Address - City:CLIVE
Practice Address - State:IA
Practice Address - Zip Code:50325-8205
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:515-557-3186
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UNITYPOINT AT HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-04
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0201763Medicaid
IA5360980006Medicare NSC