=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982691002
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2005
-----------------------------------------------------
Last Update Date | 03/21/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 401 S VAN BUREN ST
-----------------------------------------------------
City | MOUNT PLEASANT
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52641-2232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-385-5350
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 407 S WHITE ST
-----------------------------------------------------
City | MT PLEASANT
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52641-2263
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-385-3141
-----------------------------------------------------
Fax | 319-385-6571
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER-FINANCE
-----------------------------------------------------
Name | BRANDY WILLIAMS-LOWE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 319-385-6529
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------