Healthcare Provider Details

I. General information

NPI: 1467434225
Provider Name (Legal Business Name): BOONE COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 10/10/2023
Certification Date: 10/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 UNION ST
BOONE IA
50036-4821
US

IV. Provider business mailing address

1015 UNION ST
BOONE IA
50036-4821
US

V. Phone/Fax

Practice location:
  • Phone: 515-433-8470
  • Fax: 515-433-8905
Mailing address:
  • Phone: 515-432-3140
  • Fax: 515-433-8905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number161372
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number080125H
License Number StateIA

VIII. Authorized Official

Name: MIKAELA KIENITZ
Title or Position: CEO
Credential:
Phone: 515-432-3140