Healthcare Provider Details

I. General information

NPI: 1538199617
Provider Name (Legal Business Name): MARIAN HEALTH CENTER-SMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 5TH ST
SIOUX CITY IA
51101-1326
US

IV. Provider business mailing address

801 5TH ST
SIOUX CITY IA
51101-1326
US

V. Phone/Fax

Practice location:
  • Phone: 712-279-2010
  • Fax: 712-279-5681
Mailing address:
  • Phone: 712-279-2010
  • Fax: 712-279-5681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number970112H
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License Number970112H
License Number StateIA

VIII. Authorized Official

Name: JESICA HANSON
Title or Position: VP FINANCE
Credential:
Phone: 712-279-5850