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General NPI Number Information
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NPI Number | 1003968256
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Entity Type | Organization
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Legal Business Name | IDA COUNTY IOWA COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 03/16/2021
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Provider Practice Location Address
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Address Line | 700 E 2ND ST
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City | IDA GROVE
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State | IA
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Zip | 51445-1601
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Country | US
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Telephone | 712-364-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 700 E 2ND ST
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City | IDA GROVE
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State | IA
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Zip | 51445-1601
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Country | US
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Telephone | 712-364-3311
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | JONI G SCHUMANN
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Credential |
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Telephone | 712-364-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 470061H
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License Number State | IA
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