Healthcare Provider Details

I. General information

NPI: 1245329960
Provider Name (Legal Business Name): HEGG MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 10/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 21ST AVE
ROCK VALLEY IA
51247-1420
US

IV. Provider business mailing address

1202 21ST AVE
ROCK VALLEY IA
51247-1420
US

V. Phone/Fax

Practice location:
  • Phone: 712-476-8000
  • Fax: 712-476-8110
Mailing address:
  • Phone: 712-476-8000
  • Fax: 712-476-8110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number840049H
License Number StateIA

VIII. Authorized Official

Name: GLENN ZEVENBERGEN
Title or Position: CEO
Credential:
Phone: 712-476-8009