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NPI Code Detail

MEDICARE: SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL

MEDICARE: SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1275N00000XMedicare Defined Swing Bed Hospital Unit830103HIA
2282NC0060XCritical Access Hospital830103HIA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043316953
Entity Type Code : Organization
Provider Name (Legal Business Name) : SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 1213 GARFIELD AVE
Second Line :
City : HARLAN
State : IA
Zip : 51537-2057
Country : US
Telephone Number : 712-755-5161
Fax Number : 712-755-4412
Provider Business Practice Location Address
First Line : 1213 GARFIELD AVE
Second Line :
City : HARLAN
State : IA
Zip : 51537-2057
Country : US
Telephone Number : 712-755-5161
Fax Number : 712-755-4412
Authorized Official
Title or Position : CEO
Name : MR. BARRY A. JACOBSEN
Credential :
Telephone Number : 712-755-4315
Provider Enumeration Date : 09/16/2006
Last Update Date : 12/13/2010

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Directions to “SHELBY COUNTY CHRIS A MYRTUE MEMORIAL HOSPITAL ” Practice Location

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