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General NPI Number Information
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NPI Number | 1336231091
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Entity Type | Organization
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Legal Business Name | ALLEN MEMORIAL HOSPITAL CORPORATION
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 11/08/2016
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Provider Practice Location Address
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Address Line | 1825 LOGAN AVE
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City | WATERLOO
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State | IA
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Zip | 50703-1916
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Country | US
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Telephone | 319-235-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 1825 LOGAN AVENUE
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City | WATERLOO
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State | IA
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Zip | 50703
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Country | US
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Telephone | 319-235-3941
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MS. PAMELA K. DELAGARDELLE
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Credential |
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Telephone | 319-235-3987
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 070034H
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License Number State | IA
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