Healthcare Provider Details

I. General information

NPI: 1336281245
Provider Name (Legal Business Name): PEOPLE'S MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 1ST ST E
INDEPENDENCE IA
50644-3155
US

IV. Provider business mailing address

1600 1ST ST E
INDEPENDENCE IA
50644-3155
US

V. Phone/Fax

Practice location:
  • Phone: 319-332-0999
  • Fax: 319-332-0958
Mailing address:
  • Phone: 319-332-0999
  • Fax: 319-332-0958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: WADE E WEIS
Title or Position: CEO
Credential:
Phone: 319-332-0999