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General NPI Number Information
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NPI Number | 1750354676
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Entity Type | Organization
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Legal Business Name | DELAWARE COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 02/10/2006
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Last Update Date | 09/27/2013
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Provider Practice Location Address
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Address Line | 709 W MAIN ST
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City | MANCHESTER
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State | IA
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Zip | 52057-1526
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Country | US
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Telephone | 563-927-3232
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Fax |
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Provider Business Mailing Address
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Address Line | 709 W MAIN ST PO BOX 359
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City | MANCHESTER
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State | IA
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Zip | 52057-1526
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Country | US
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Telephone | 563-927-3232
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. LON BUTIKOFER
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Credential | RN, PHD
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Telephone | 563-927-3232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 280123H
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License Number State | IA
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