Healthcare Provider Details

I. General information

NPI: 1902886039
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: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 S CLARK ST
CARROLL IA
51401-3038
US

IV. Provider business mailing address

PO BOX 628
CARROLL IA
51401-0628
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number140090H
License Number StateIA

VIII. Authorized Official

Name: ALLEN ANDERSON
Title or Position: CEO
Credential:
Phone: 712-794-5025