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General NPI Number Information
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NPI Number | 1154474609
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Entity Type | Organization
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Legal Business Name | DELAWARE COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 345 1ST ST S
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City | WINTHROP
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State | IA
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Zip | 50682-9759
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Country | US
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Telephone | 319-935-3343
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Fax | 319-935-3331
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Provider Business Mailing Address
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Address Line | PO BOX 359
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City | MANCHESTER
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State | IA
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Zip | 52057-0359
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Country | US
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Telephone | 563-927-7457
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Fax | 563-927-7557
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Authorized Official
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Title or Position | CEO
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Name | DR. LON BUTIKOFER
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Credential | RN, PHD
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Telephone | 563-927-7308
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 280123H
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License Number State | IA
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