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NPI Code Detail

MEDICARE: HEGG MEMORIAL HOSPITAL

MEDICARE: HEGG 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
1332B00000XDurable Medical Equipment & Medical Supplies
2207Q00000XFamily Medicine PhysicianIA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629023429
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEGG MEMORIAL HOSPITAL
Provider Business Mailing Address
First Line : 2121 HEGG DR
Second Line :
City : ROCK VALLEY
State : IA
Zip : 51247-1445
Country : US
Telephone Number : 712-476-8100
Fax Number : 712-476-8190
Provider Business Practice Location Address
First Line : 1202 21ST AVENUE
Second Line :
City : ROCK VALLEY
State : IA
Zip : 51247-1445
Country : US
Telephone Number : 712-476-8100
Fax Number : 712-476-8190
Authorized Official
Title or Position : CLINIC MANAGER
Name : MRS. VALERIE LADD LOUDENBACK
Credential :
Telephone Number : 712-476-8150
Provider Enumeration Date : 05/23/2006
Last Update Date : 08/10/2009

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1114243078 — JONATHAN H ENGBERS MD
Practice Location Address:
2121 HEGG DR
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51247-1445
Practice Phone: 712-476-8150
Practice Fax: 712-476-8190

Directions to “HEGG MEMORIAL HOSPITAL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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