Healthcare Provider Details

I. General information

NPI: 1992960876
Provider Name (Legal Business Name): CASS COUNTY MEMORIAL HOSPITAL RHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2008
Last Update Date: 01/16/2023
Certification Date: 01/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 E 10TH ST STE 100
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: 712-243-2850
  • Fax: 712-243-7423
Mailing address:
  • Phone: 712-243-2850
  • Fax: 712-243-7423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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