Healthcare Provider Details

I. General information

NPI: 1508964123
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: 09/20/2006
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N 8TH ST
MISSOURI VALLEY IA
51555-1102
US

IV. Provider business mailing address

PO BOX 776220
CHICAGO IL
60677-6220
US

V. Phone/Fax

Practice location:
  • Phone: 712-642-2784
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number430030
License Number StateIA

VIII. Authorized Official

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