Healthcare Provider Details

I. General information

NPI: 1932203130
Provider Name (Legal Business Name): REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 06/29/2022
Certification Date: 06/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 8TH AVE W
CRESCO IA
52136-1062
US

IV. Provider business mailing address

235 8TH AVE W
CRESCO IA
52136-1062
US

V. Phone/Fax

Practice location:
  • Phone: 563-547-2101
  • Fax: 563-547-3448
Mailing address:
  • Phone: 563-547-2101
  • Fax: 563-547-3448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number450057H
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier23415
Identifier TypeOTHER
Identifier StateIA
Identifier IssuerBLUE CROSS OF IA
# 2
Identifier0234153
Identifier TypeMEDICAID
Identifier StateIA
Identifier Issuer

VIII. Authorized Official

Name: GREGORY BURKEL
Title or Position: EFO
Credential:
Phone: 563-547-2022