Healthcare Provider Details

I. General information

NPI: 1912999467
Provider Name (Legal Business Name): CRAWFORD COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 03/26/2024
Certification Date: 03/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MEDICAL PARKWAY
DENISON IA
51442-2299
US

IV. Provider business mailing address

100 MEDICAL PARKWAY
DENISON IA
51442-2299
US

V. Phone/Fax

Practice location:
  • Phone: 712-265-2500
  • Fax: 712-265-2511
Mailing address:
  • Phone: 712-265-2500
  • Fax: 712-265-2511

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number240173H
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number240173H
License Number StateIA

VIII. Authorized Official

Name: ERIN C MUCK
Title or Position: PRESIDENT/CEO
Credential:
Phone: 712-265-2506