1316148307 NPI number — CASS COUNTY MEMORIAL HOSPITAL

Table of content: (NPI 1316148307)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1316148307 NPI number — CASS COUNTY MEMORIAL HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CASS COUNTY MEMORIAL HOSPITAL
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:
GRISWOLD MEDICAL CENTER RHC
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:
1316148307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1109 MORNINGSIDE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRISWOLD
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51535-0099
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-778-5140
Provider Business Mailing Address Fax Number:
712-243-7423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1501 E 10TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ATLANTIC
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50022-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-243-2850
Provider Business Practice Location Address Fax Number:
712-243-7423
Provider Enumeration Date:
05/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STANGL
Authorized Official First Name:
ABBEY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
712-243-3250

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1316148307 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com