Healthcare Provider Details

I. General information

NPI: 1174572481
Provider Name (Legal Business Name): PALMER LUTHERAN HEALTH CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 08/03/2022
Certification Date: 08/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JEFFERSON ST
WEST UNION IA
52175-1024
US

IV. Provider business mailing address

200 JEFFERSON ST
WEST UNION IA
52175-1024
US

V. Phone/Fax

Practice location:
  • Phone: 563-422-6267
  • Fax: 563-422-9876
Mailing address:
  • Phone: 563-422-6267
  • Fax: 563-422-9876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: PATRICE KUENNEN
Title or Position: CEO
Credential:
Phone: 563-422-3811