1922078070 NPI number — FLOYD COUNTY MEMORIAL HOSPITAL COMMISSION

Table of content: (NPI 1922078070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922078070 NPI number — FLOYD COUNTY MEMORIAL HOSPITAL COMMISSION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FLOYD COUNTY MEMORIAL HOSPITAL COMMISSION
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:
Provider Other Organization Name Type Code:
6
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:
1922078070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/07/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
800 11TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLES CITY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50616-3499
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
641-228-6830
Provider Business Mailing Address Fax Number:
641-257-4336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 WOODBRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NASHUA
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50658-7775
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
641-435-4181
Provider Business Practice Location Address Fax Number:
641-435-2458
Provider Enumeration Date:
01/23/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIS
Authorized Official First Name:
DAWNETT
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
641-228-6830

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  340138H , 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: 0283093 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 28309 . This is a "WELLMARK BCBS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




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