=====================================================
General NPI Number Information
=====================================================
NPI Number | 1306059506
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GRINNELL REGIONAL MEDICAL CENTER, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2007
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 210 FOURTH AVENUE
-----------------------------------------------------
City | GRINNELL
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50112
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 641-236-2913
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 255 W. MICHIGAN AVE.
-----------------------------------------------------
City | JACKSON
-----------------------------------------------------
State | MI
-----------------------------------------------------
Zip | 49201
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 517-787-6440
-----------------------------------------------------
Fax | 517-787-4146
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | VICE PRECIDENT
-----------------------------------------------------
Name | TODD LINDEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 641-236-2913
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207L00000X
-----------------------------------------------------
Taxonomy Name | Anesthesiology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367500000X
-----------------------------------------------------
Taxonomy Name | Certified Registered Nurse Anesthetist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------