Healthcare Provider Details

I. General information

NPI: 1013025790
Provider Name (Legal Business Name): POCAHONTAS COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 NW 7TH ST
POCAHONTAS IA
50574-1099
US

IV. Provider business mailing address

606 NW 7TH ST
POCAHONTAS IA
50574-1099
US

V. Phone/Fax

Practice location:
  • Phone: 712-335-3430
  • Fax: 712-335-4116
Mailing address:
  • Phone: 712-335-3501
  • Fax: 712-335-4116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JAMES D. ROETMAN
Title or Position: CEO
Credential:
Phone: 712-335-3501