1952417396 NPI number — KNOXVILLE COMMUNITY HOSPITAL, INC.

Table of content: (NPI 1952417396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952417396 NPI number — KNOXVILLE COMMUNITY HOSPITAL, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOXVILLE COMMUNITY HOSPITAL, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
KNOXVILLE HOSPITAL & CLINICS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1952417396
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1002 S LINCOLN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KNOXVILLE
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50138-3121
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-842-2151
Provider Business Mailing Address Fax Number:
641-842-1470

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
113 N MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MELCHER
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-947-2121
Provider Business Practice Location Address Fax Number:
641-947-4101
Provider Enumeration Date:
08/21/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HELWIG
Authorized Official First Name:
ANN
Authorized Official Middle Name:
MARGARET
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
641-842-2151

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  630031H , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 36313 . This is a "WELLMARK BCBS IOWA" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 0433995 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".