Healthcare Provider Details

I. General information

NPI: 1124043153
Provider Name (Legal Business Name): WAVERLY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 06/05/2024
Certification Date: 06/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 9TH ST SW
WAVERLY IA
50677-2929
US

IV. Provider business mailing address

312 9TH ST SW
WAVERLY IA
50677-2929
US

V. Phone/Fax

Practice location:
  • Phone: 319-352-4120
  • Fax: 319-352-3992
Mailing address:
  • Phone: 319-352-4120
  • Fax: 319-352-3992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number090098H
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number090098H
License Number StateIA

VIII. Authorized Official

Name: MS. JODI M GEERTS
Title or Position: CEO
Credential:
Phone: 319-352-4120