Healthcare Provider Details

I. General information

NPI: 1720901408
Provider Name (Legal Business Name): SIOUXLAND COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 WAR EAGLE DR
SIOUX CITY IA
51109-1700
US

IV. Provider business mailing address

4230 WAR EAGLE DR
SIOUX CITY IA
51109-1700
US

V. Phone/Fax

Practice location:
  • Phone: 712-224-4320
  • Fax: 712-224-4341
Mailing address:
  • Phone: 712-224-4320
  • Fax: 712-224-4341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MARK ANDREW DONALDSON
Title or Position: CEO
Credential:
Phone: 712-226-9010