Healthcare Provider Details

I. General information

NPI: 1942893839
Provider Name (Legal Business Name): WASHINGTON COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/11/2021
Last Update Date: 02/22/2021
Certification Date: 02/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E WALNUT ST
COLUMBUS JUNCTION IA
52738-1014
US

IV. Provider business mailing address

PO BOX 909
WASHINGTON IA
52353-0909
US

V. Phone/Fax

Practice location:
  • Phone: 319-728-2429
  • Fax:
Mailing address:
  • Phone: 319-653-5481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ANNIE DECHANT
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 319-863-3904