Healthcare Provider Details

I. General information

NPI: 1275513988
Provider Name (Legal Business Name): MAHASKA COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 C AVE E
OSKALOOSA IA
52577-4298
US

IV. Provider business mailing address

1229 C AVE E
OSKALOOSA IA
52577-4298
US

V. Phone/Fax

Practice location:
  • Phone: 641-672-3100
  • Fax: 641-672-3336
Mailing address:
  • Phone: 641-672-3100
  • Fax: 641-672-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number620092H
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number620092H
License Number StateIA

VIII. Authorized Official

Name: KEVIN DERONDE
Title or Position: CEO
Credential:
Phone: 402-691-5528