Healthcare Provider Details

I. General information

NPI: 1518947647
Provider Name (Legal Business Name): ST. ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 02/15/2024
Certification Date: 02/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1524 E US HIGHWAY 30
CARROLL IA
51401-2659
US

IV. Provider business mailing address

311 S CLARK ST
CARROLL IA
51401-3038
US

V. Phone/Fax

Practice location:
  • Phone: 712-792-5279
  • Fax: 712-794-5937
Mailing address:
  • Phone: 712-792-3581
  • Fax: 712-792-2124

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number140090H
License Number StateIA

VIII. Authorized Official

Name: ERIC SALMONSON
Title or Position: CFO
Credential:
Phone: 712-794-5424