Healthcare Provider Details

I. General information

NPI: 1104939040
Provider Name (Legal Business Name): PALO ALTO COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2006
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 1ST ST
EMMETSBURG IA
50536-2516
US

IV. Provider business mailing address

3201 1ST ST
EMMETSBURG IA
50536-2516
US

V. Phone/Fax

Practice location:
  • Phone: 712-852-5500
  • Fax: 712-852-5477
Mailing address:
  • Phone: 712-852-5500
  • Fax: 712-852-5477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number740045H
License Number StateIA

VIII. Authorized Official

Name: DESIREE A EINSWEILER
Title or Position: ADMINISTRATOR/CEO
Credential:
Phone: 712-852-5401