Healthcare Provider Details

I. General information

NPI: 1902593965
Provider Name (Legal Business Name): HENRY COUNTY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2023
Last Update Date: 04/20/2023
Certification Date: 04/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N ORCHARD ST
MEDIAPOLIS IA
52637-7722
US

IV. Provider business mailing address

1221 S GEAR AVE
WEST BURLINGTON IA
52655-1679
US

V. Phone/Fax

Practice location:
  • Phone: 319-394-3177
  • Fax:
Mailing address:
  • Phone: 319-768-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERESA LYNN COLGAN
Title or Position: CEO
Credential:
Phone: 319-385-6560