Healthcare Provider Details

I. General information

NPI: 1942381538
Provider Name (Legal Business Name): ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1502 MADISON ST
BEDFORD IA
50833-1043
US

IV. Provider business mailing address

1502 MADISON ST
BEDFORD IA
50833-1043
US

V. Phone/Fax

Practice location:
  • Phone: 712-523-2196
  • Fax: 712-523-2198
Mailing address:
  • Phone: 712-523-2196
  • Fax: 712-523-2198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number873479
License Number StateIA

VIII. Authorized Official

Name: EVERT KUIPER
Title or Position: CEO - CHI HEALTH
Credential:
Phone: 402-343-4420