Healthcare Provider Details

I. General information

NPI: 1992730857
Provider Name (Legal Business Name): DALLAS COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 02/26/2020
Certification Date: 02/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 10TH ST
PERRY IA
50220-2221
US

IV. Provider business mailing address

610 10TH ST
PERRY IA
50220-2221
US

V. Phone/Fax

Practice location:
  • Phone: 515-465-3547
  • Fax: 515-465-2922
Mailing address:
  • Phone: 515-465-3547
  • Fax: 515-465-2922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number250157H
License Number StateIA

VIII. Authorized Official

Name: RANDY LOOMIS
Title or Position: CFO
Credential:
Phone: 515-465-7653