Healthcare Provider Details

I. General information

NPI: 1962654921
Provider Name (Legal Business Name): GUTHRIE COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2008
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 SE 13TH ST
PANORA IA
50216-4500
US

IV. Provider business mailing address

710 N 12TH ST
GUTHRIE CENTER IA
50115-1549
US

V. Phone/Fax

Practice location:
  • Phone: 641-755-4000
  • Fax: 641-755-3541
Mailing address:
  • Phone: 641-332-2201
  • Fax: 641-332-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number28764
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER R STIPE
Title or Position: CEO
Credential:
Phone: 641-332-2201