Healthcare Provider Details

I. General information

NPI: 1356726475
Provider Name (Legal Business Name): DELAWARE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2015
Last Update Date: 07/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 W MAIN ST
MANCHESTER IA
52057-1527
US

IV. Provider business mailing address

709 W MAIN ST PO BOX 359
MANCHESTER IA
52057-1526
US

V. Phone/Fax

Practice location:
  • Phone: 563-927-7353
  • Fax: 563-927-7520
Mailing address:
  • Phone: 563-927-7457
  • Fax: 563-927-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: LON BUTIKOFER
Title or Position: CEO
Credential: RN, PHD
Phone: 563-927-7308