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General NPI Number Information
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NPI Number | 1467458877
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Entity Type | Organization
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Legal Business Name | GREATER REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 06/22/2005
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Last Update Date | 02/28/2012
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Provider Practice Location Address
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Address Line | 1715 W PRAIRIE ST SUITE A
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City | CRESTON
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State | IA
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Zip | 50801-1325
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Country | US
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Telephone | 641-782-3528
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Fax | 641-782-3541
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Provider Business Mailing Address
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Address Line | 1715 W PRAIRIE ST SUITE A
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City | CRESTON
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State | IA
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Zip | 50801-1325
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Country | US
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Telephone | 641-782-3528
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Fax | 641-782-3541
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. LOUANN SNODGRASS
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Credential | LISW
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Telephone | 641-782-3515
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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 | IA
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