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General NPI Number Information
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NPI Number | 1124183785
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Entity Type | Organization
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Legal Business Name | TRINITY REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 802 KENYON RD
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City | FORT DODGE
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State | IA
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Zip | 50501-5740
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Country | US
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Telephone | 515-573-3101
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7021
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City | DES MOINES
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State | IA
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Zip | 50309-7021
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Country | US
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Telephone | 515-573-3101
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. MIKE J DEWERFF
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Credential |
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Telephone | 515-574-6603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 940001H
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License Number State | IA
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