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General NPI Number Information
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NPI Number | 1689249922
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Entity Type | Organization
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Legal Business Name | IDA COUNTY IOWA COMMUNITY HOSPITAL
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Dates
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Enumeration Date | 05/20/2021
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 1400 S KIEL ST
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City | HOLSTEIN
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State | IA
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Zip | 51025-5091
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Country | US
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Telephone | 712-368-6300
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Fax | 712-368-6304
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Provider Business Mailing Address
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Address Line | 701 E 2ND ST
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City | IDA GROVE
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State | IA
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Zip | 51445-1699
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Country | US
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Telephone | 712-364-3311
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | GLEN J WINEKAUF
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Credential |
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Telephone | 712-364-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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