Healthcare Provider Details

I. General information

NPI: 1790906642
Provider Name (Legal Business Name): VAN BUREN COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 FRANKLIN ST
KEOSAUQUA IA
52565-1164
US

IV. Provider business mailing address

304 FRANKLIN STREET PO BOX 70
KEOSAUQUA IA
52565-1164
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateIA

VIII. Authorized Official

Name: LISA SCHNEDLER
Title or Position: ADMINISTRATOR
Credential:
Phone: 319-293-3171