Healthcare Provider Details

I. General information

NPI: 1255107959
Provider Name (Legal Business Name): MAHASKA COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 C AVE E STE 100
OSKALOOSA IA
52577-4246
US

IV. Provider business mailing address

1229 C AVE E
OSKALOOSA IA
52577-4298
US

V. Phone/Fax

Practice location:
  • Phone: 641-672-3144
  • Fax:
Mailing address:
  • Phone: 641-672-3144
  • Fax: 641-672-3146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: KEVIN DERONDE
Title or Position: CEO
Credential:
Phone: 641-672-3236