Healthcare Provider Details

I. General information

NPI: 1003868845
Provider Name (Legal Business Name): HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 05/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 S WHITE ST
MT PLEASANT IA
52641-2262
US

IV. Provider business mailing address

407 S WHITE ST
MT PLEASANT IA
52641-2262
US

V. Phone/Fax

Practice location:
  • Phone: 319-385-3141
  • Fax: 319-385-6571
Mailing address:
  • Phone: 319-385-3141
  • Fax: 319-385-6571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateIA

VIII. Authorized Official

Name: MR. DAVE J MUHS
Title or Position: CFO
Credential:
Phone: 319-385-6716