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General NPI Number Information
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NPI Number | 1396847521
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Entity Type | Organization
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Legal Business Name | SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 09/01/2006
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Last Update Date | 12/13/2010
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Provider Practice Location Address
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Address Line | 2712 12TH ST
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City | HARLAN
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State | IA
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Zip | 51537-2306
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Country | US
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Telephone | 712-755-4308
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Fax | 712-755-4375
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Provider Business Mailing Address
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Address Line | 1213 GARFIELD AVE
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City | HARLAN
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State | IA
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Zip | 51537-2057
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Country | US
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Telephone | 712-755-5161
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Fax | 712-755-4412
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Authorized Official
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Title or Position | CEO
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Name | MR. BARRY A. JACOBSEN
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Credential |
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Telephone | 712-755-4315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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