Healthcare Provider Details

I. General information

NPI: 1700961273
Provider Name (Legal Business Name): ALEGENT HEALTH COMMUNITY MEMORIAL HOSPITAL OF MISSOURI VALLEY, IOWA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 ELM ST
MISSOURI VALLEY IA
51555-1140
US

IV. Provider business mailing address

809 ELM ST
MISSOURI VALLEY IA
51555-1140
US

V. Phone/Fax

Practice location:
  • Phone: 712-642-2794
  • Fax: 712-642-4221
Mailing address:
  • Phone: 712-642-2794
  • Fax: 712-642-4221

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: EVERT KUIPER
Title or Position: CEO - CHI HEALTH
Credential:
Phone: 402-343-4420