NPIMap

State University of Iowa

Organization Active NPI Clinic Pharmacy · Coralville, IA

NPI 1811246473 · NPPES record last updated Feb 14, 2025

Key facts

NPI
1811246473
Entity type
Organization (NPI type 2)
Primary specialty
Clinic Pharmacy 3336C0002X
License
1419 (IA)
Legal business name
STATE UNIVERSITY OF IOWA
Practice address
105 E 9TH Street
Suite a
Coralville, IA 52241
Phone
(319) 467-2050
Fax
(319) 467-2070
NPI assigned
Aug 29, 2012
Organization subpart
No

Authorized official

Name
Joe M McKelvey
Title
Sr Dir of Govt Reimbursement
Phone
(319) 467-8549

Owned or controlled facilities with NPI records 4

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

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 20

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

Corporate family (same tax ID) 21

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

Practitioners 1,887

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 1,887

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in IA

All facility ownership & control disclosures 4

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

FacilityTypeRoleSince
University of Iowa Health Care Medical Center
Iowa City, IA · CCN 160058		 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical Center
Iowa City, IA · CCN 16S058		 Hospital Other Jul 1, 1966
University of Iowa Health Care Medical Center Downtown
Iowa City, IA · CCN 160029		 Hospital Other Jan 31, 2024
University of Iowa Health Care Medical Center Downtown Home Health
Coralville, IA · CCN 167181		 Home health agency Other Jan 31, 2024

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20130129000169 IA DME Supplier - Pharmacy 7618884230 Practice locations: Coralville, IA
O20230420000460 IA Part B Supplier - Mass Immunization (Roster Biller Only) 7618884230 6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Coralville, IA; Des Moines, IA; Iowa City, IA; North Liberty, IA; Riverside, IA

National Provider Directory

Tax ID family
Louis V Kirchoff MD (57 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 1419 IA Yes

Addresses

Primary practice location

105 E 9TH Street
Suite a
Coralville, IA 52241

Mailing address

105 E 9TH Street
Suite a
Coralville, IA 52241
Phone (319) 467-2050

Other identifiers

IdentifierTypeStateIssuer
1107919OtherIACONTROLLED SUBSTANCE REGISTRATION
1419OtherIASTATE PHARMACY LICENSE

Other names

  • UI Healthcare-Iowa River Landing Pharmacy Doing business as

Other providers in Coralville, IA

All providers in Coralville, IA · Clinic Pharmacy in Iowa

Sources for this page

Verify at the official NPI Registry.