Healthcare Provider Details

I. General information

NPI: 1508810714
Provider Name (Legal Business Name): VAN BUREN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2006
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 FRANKLIN ST
KEOSAUQUA IA
52565-1164
US

IV. Provider business mailing address

304 FRANKLIN ST
KEOSAUQUA IA
52565-1164
US

V. Phone/Fax

Practice location:
  • Phone: 319-293-3171
  • Fax: 319-293-6314
Mailing address:
  • Phone: 319-293-3171
  • Fax: 319-293-6314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number890026H
License Number StateIA

VIII. Authorized Official

Name: MS. KARA M MCENTEE
Title or Position: CFO
Credential:
Phone: 319-293-3171