Healthcare Provider Details

I. General information

NPI: 1487728895
Provider Name (Legal Business Name): GRINNELL REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 4TH AVE
GRINNELL IA
50112-1898
US

IV. Provider business mailing address

210 4TH AVE
GRINNELL IA
50112-1898
US

V. Phone/Fax

Practice location:
  • Phone: 641-236-2567
  • Fax: 641-236-2599
Mailing address:
  • Phone: 641-236-2567
  • Fax: 641-236-2599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TODD LINDEN
Title or Position: PRESIDENT
Credential:
Phone: 641-236-2300