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General NPI Number Information
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NPI Number | 1184723702
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Entity Type | Organization
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Legal Business Name | ELLSWORTH MUNICIPAL HOSPITAL
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 12/03/2020
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Provider Practice Location Address
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Address Line | 520 TALBOTT ST STE 3 EMH PHYSICIANS CLINIC
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City | IOWA FALLS
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State | IA
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Zip | 50126-2379
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Country | US
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Telephone | 641-648-6491
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Fax | 641-648-7088
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Provider Business Mailing Address
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Address Line | 520 TALBOTT ST STE 3 EMH PHYSICIANS CLINIC
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City | IOWA FALLS
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State | IA
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Zip | 50126-2379
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Country | US
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Telephone | 641-648-6491
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Fax | 641-648-7088
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Authorized Official
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Title or Position | CFO
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Name | MR. MICHAEL WHITE
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Credential |
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Telephone | 641-648-4631
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number | 420156H
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License Number State | IA
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