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General NPI Number Information
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NPI Number | 1912089848
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Entity Type | Organization
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Legal Business Name | HUMBOLDT COUNTY MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 1000 15TH ST N
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City | HUMBOLDT
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State | IA
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Zip | 50548-1008
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Country | US
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Telephone | 515-332-4200
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Fax | 515-332-4820
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Provider Business Mailing Address
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Address Line | 1000 15TH ST N
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City | HUMBOLDT
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State | IA
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Zip | 50548-1008
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Country | US
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Telephone | 515-332-4200
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Fax | 515-332-4820
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Authorized Official
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Title or Position | CFO
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Name | MS. HEATHER L. SHAULL
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Credential |
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Telephone | 515-332-4200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 460155H
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License Number State | IA
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