Healthcare Provider Details

I. General information

NPI: 1043747280
Provider Name (Legal Business Name): CASS COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2017
Last Update Date: 07/28/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E 10TH ST STE 200
ATLANTIC IA
50022-1936
US

IV. Provider business mailing address

1501 E 10TH ST
ATLANTIC IA
50022-1936
US

V. Phone/Fax

Practice location:
  • Phone: 712-243-7540
  • Fax: 712-243-7544
Mailing address:
  • Phone: 712-243-3250
  • Fax: 712-243-7587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: MS. ABBEY L STANGL
Title or Position: CFO
Credential:
Phone: 712-243-7804