Healthcare Provider Details

I. General information

NPI: 1003886110
Provider Name (Legal Business Name): MAHASKA COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2006
Last Update Date: 10/28/2024
Certification Date: 10/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 N 12TH ST
OSKALOOSA IA
52577-2466
US

IV. Provider business mailing address

1229 C AVE E
OSKALOOSA IA
52577-4298
US

V. Phone/Fax

Practice location:
  • Phone: 641-672-3470
  • Fax: 641-672-3336
Mailing address:
  • Phone: 641-672-3236
  • Fax: 641-372-3336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: KEVIN DERONDE
Title or Position: CEO
Credential:
Phone: 641-672-3100