Healthcare Provider Details

I. General information

NPI: 1659359867
Provider Name (Legal Business Name): HUMBOLDT COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 15TH ST N
HUMBOLDT IA
50548-1008
US

IV. Provider business mailing address

1012 15TH ST N
HUMBOLDT IA
50548-1008
US

V. Phone/Fax

Practice location:
  • Phone: 515-332-2492
  • Fax: 515-332-4756
Mailing address:
  • Phone: 515-332-2492
  • Fax: 515-332-4756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateIA
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. MICHELLE FEASTER
Title or Position: ADMINISTRATOR
Credential: LBSW
Phone: 515-332-2492