NPIMap

Organization Active NPI

Central Iowa Hospital Corporation

Doing business as IMMC Outpatient Pharmacy

  • Pharmacy
  • Des Moines, IA
National Provider Identifier
1003352949
Registry record updated Mar 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
1591 Issued in IA
Legal business name
CENTRAL IOWA HOSPITAL CORPORATION
Doing business as
IMMC Outpatient Pharmacy
Practice address
1200 Pleasant St
Des Moines, IA 50309-1406
Phone
(515) 241-5936
Fax
(515) 241-5925
NPI assigned
Jan 17, 2017
Last updated
Mar 16, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Angela Boord
Title
Pharmacy Operations Manager
Phone
(515) 241-5942

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 1591 IA Primary
Community/Retail Pharmacy 3336C0003X

Addresses

Primary practice location

1200 Pleasant St
Des Moines, IA 50309-1406

Mailing address

1200 Pleasant St
Des Moines, IA 50309-1406
Phone (515) 241-5942

Other names 1

  • IMMC Outpatient Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191030003638 IA DME Supplier - Pharmacy 1052229275 Practice locations: Des Moines, IA

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Immc Outpatient Pharmacy1200 Pleasant St, Des Moines, IA 50309-1406(515) 241-5936 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since Jan 1, 1992

National Provider Directory

National Provider Directory
Tax ID family
Kenneth Sladkin MD21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

Organizations that report the same tax identification number in the National Provider Directory.

View all 20

Locations (25 of 47)

1105 N Ankeny Blvd
Ankeny, IA 50023
Phone (515) 255-8399

2701 SE Convenience Blvd
Ste 8
Ankeny, IA 50021
Phone (515) 963-7924

3625 N Ankeny Blvd
Ste K
Ankeny, IA 50023
Phone (515) 965-4681

1204 Linden St
Dallas Center, IA 50063
Phone (515) 729-0024

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1200 Pleasant St
Ste 509
Des Moines, IA 50309
Phone (515) 241-3218

1201 Pennsylvania Ave
Des Moines, IA 50316
Phone (515) 266-1000

1206 Pleasant St
Des Moines, IA 50309
Phone (515) 241-3434

1206 Pleasant St
#1
Des Moines, IA 50309
Phone (515) 263-5153

1206 Pleasant St
Ste 218
Des Moines, IA 50309
Phone (515) 241-6546

1212 Pleasant St
#5
Des Moines, IA 50309
Phone (515) 309-6011

1212 Pleasant St
Ste 109
Des Moines, IA 50309
Phone (515) 241-8141

1212 Pleasant St
Ste LL9
Des Moines, IA 50309
Phone (515) 241-8878

1215 Pleasant St
#305
Des Moines, IA 50309
Phone (515) 241-6500

1215 Pleasant St
Ste 304
Des Moines, IA 50309
Phone (515) 241-3413

1215 Pleasant St
Ste 508
Des Moines, IA 50309
Phone (515) 241-4176

1221 Pleasant St
#A170
Des Moines, IA 50309
Phone (515) 241-4373

1221 Pleasant St
Ste 250
Des Moines, IA 50309
Phone (515) 241-4674

1221 Pleasant St
Ste 430
Des Moines, IA 50309
Phone (515) 241-4099

1221 Pleasant St
Ste 470
Des Moines, IA 50309
Phone (515) 241-4099

1301 Pennsylvania Ave
Ste 304
Des Moines, IA 50316
Phone (515) 265-1300

1301 Pennsylvania Ave
Ste 306
Des Moines, IA 50316
Phone (515) 263-5143

1301 Pennsylvania Ave
Ste 308
Des Moines, IA 50316
Phone (515) 263-3732

1415 Woodland Ave
Ste 238
Des Moines, IA 50309
Phone (515) 241-5811

1800 Grand Ave
Rm 142
Des Moines, IA 50309
Phone (515) 242-7246

Ownership & related parties

All facility ownership & control disclosures 27

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Guthrie County HospitalGuthrie Center, IA, CCN 161314 Hospital Operational/Managerial Control Jan 1, 2014
Clarke County HospitalOsceola, IA, CCN 161348 Hospital Operational/Managerial Control Dec 1, 1987
Lucas County Health CenterChariton, IA, CCN 161341 Hospital Operational/Managerial Control Sep 1, 2015
Guthrie County HospitalGuthrie Center, IA, CCN 16Z314 Hospital Operational/Managerial Control Jan 1, 2014
Clarke County HospitalOsceola, IA, CCN 16Z348 Hospital Operational/Managerial Control Dec 1, 1987
Greater Regional Medical CenterCreston, IA, CCN 161365 Hospital Operational/Managerial Control Jul 1, 2017
Greater Regional Medical CenterCreston, IA, CCN 16Z365 Hospital Operational/Managerial Control Jul 1, 2017
Lucas County Health CenterChariton, IA, CCN 16Z341 Hospital Operational/Managerial Control Sep 1, 2015
Greene County Medical CenterJefferson, IA, CCN 161325 Hospital Operational/Managerial Control Jul 1, 2011
Unitypoint Health Des Moines Iowa Methodist Medical CenterDes Moines, IA, CCN 160082 Hospital Other Jun 22, 1982
Unitypoint Health Des Moines Iowa Methodist Medical CenterDes Moines, IA, CCN 16T082 Hospital Other Jun 22, 1982
Story County Medical CenterNevada, IA, CCN 161333 Hospital Operational/Managerial Control Feb 1, 2013
Story County Medical CenterNevada, IA, CCN 16Z333 Hospital Operational/Managerial Control Feb 1, 2013
Greene County Medical CenterJefferson, IA, CCN 16Z325 Hospital Operational/Managerial Control Jul 1, 2011
Unitypoint Health Des Moines Iowa Lutheran HospitalDes Moines, IA, CCN 16S082 Hospital Other Jun 22, 1982
Cedar Ridge VillageWest Des Moines, IA, CCN 165790 Skilled nursing facility Direct Ownership Interest (47.47%) Apr 1, 2021
Lenox Medical ClinicLenox, IA, CCN 163469 Rural health clinic Operational/Managerial Control Jul 1, 2017
Lucas County Health Center Medical ClinicChariton, IA, CCN 168560 Rural health clinic Operational/Managerial Control Sep 1, 2015
Story Medical Clinic - NevadaNevada, IA, CCN 168594 Rural health clinic Operational/Managerial Control Feb 1, 2013
Story Medical Clinic - MaxwellMaxwell, IA, CCN 168595 Rural health clinic Operational/Managerial Control Feb 1, 2013
Corning Medical ClinicCorning, IA, CCN 168636 Rural health clinic Operational/Managerial Control Jul 1, 2017
Mount Ayr Community Health ClinicMount Ayr, IA, CCN 168638 Rural health clinic Operational/Managerial Control Jul 1, 2017
Greene County Family MedicineJefferson, IA, CCN 168619 Rural health clinic Operational/Managerial Control Jul 1, 2011
Clarke County ClinicOsceola, IA, CCN 168618 Rural health clinic Operational/Managerial Control Dec 1, 1987
GCH ClinicsAdair, IA, CCN 168620 Rural health clinic Operational/Managerial Control Jan 1, 2014
GCH ClinicsStuart, IA, CCN 168632 Rural health clinic Operational/Managerial Control Jan 1, 2014
GCH ClinicsPanora, IA, CCN 168637 Rural health clinic Operational/Managerial Control Jan 1, 2014

Owned or controlled facilities with NPI records 29

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 29

Practitioners & affiliated clinicians

Practitioners 578

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 578

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489622400000",
    "number": "1003352949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 PLEASANT ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503091406",
            "telephone_number": "515-241-5936",
            "fax_number": "515-241-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL IOWA HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-03-16",
        "status": "A",
        "authorized_official_last_name": "BOORD",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS MANAGER",
        "authorized_official_telephone_number": "515-241-5942"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "IA",
            "license": "1591",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMMC Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.