Healthcare Provider Details

I. General information

NPI: 1720067127
Provider Name (Legal Business Name): ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 04/24/2024
Certification Date: 04/24/2024
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 Code282NC0060X
TaxonomyCritical Access Hospital
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License Number140090H
License Number StateIA

VIII. Authorized Official

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