Healthcare Provider Details

I. General information

NPI: 1073555462
Provider Name (Legal Business Name): CLARKE COUNTY PUBLIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 S FILLMORE ST
OSCEOLA IA
50213-1694
US

IV. Provider business mailing address

800 S FILLMORE ST
OSCEOLA IA
50213-1694
US

V. Phone/Fax

Practice location:
  • Phone: 641-342-2184
  • Fax: 641-342-5318
Mailing address:
  • Phone: 641-342-2184
  • Fax: 641-342-5318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number200012H
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number200012H
License Number StateIA

VIII. Authorized Official

Name: MRS. SUSAN DANIELS
Title or Position: CFO
Credential:
Phone: 641-342-2184