Healthcare Provider Details

I. General information

NPI: 1962572776
Provider Name (Legal Business Name): PALO ALTO COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 12/03/2020
Certification Date: 12/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 W DIVISION ST
WEST BEND IA
50597-7738
US

IV. Provider business mailing address

3201 1ST ST
EMMETSBURG IA
50536-2516
US

V. Phone/Fax

Practice location:
  • Phone: 515-887-7891
  • Fax:
Mailing address:
  • Phone: 712-852-5500
  • Fax: 712-852-5409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DESIREE A EINSWEILER
Title or Position: CEO
Credential:
Phone: 712-852-5500