Healthcare Provider Details

I. General information

NPI: 1811039886
Provider Name (Legal Business Name): DELAWARE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 E MISSION ST
STRAWBERRY POINT IA
52076
US

IV. Provider business mailing address

PO BOX 359 709 W MAIN ST
MANCHESTER IA
52057-0359
US

V. Phone/Fax

Practice location:
  • Phone: 563-933-7720
  • Fax: 563-933-6277
Mailing address:
  • Phone: 563-927-7777
  • Fax: 563-927-7518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LON BUTIKOFER
Title or Position: CEO
Credential:
Phone: 563-927-7308