MEDICARE: SIOUXLAND COMMUNITY HEALTH CENTER

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
1	3336C0002X	Clinic Pharmacy

Other Identifiers

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

General Provider Information

NPI Number	:	1700967833
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIOUXLAND COMMUNITY HEALTH CENTER

Provider Business Mailing Address
First Line	:	1021 NEBRASKA ST
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51105-1436
Country	:	US
Telephone Number	:	712-255-4204
Fax Number	:

Provider Business Practice Location Address
First Line	:	1021 NEBRASKA STREET
Second Line	:
City	:	SIOUX CITY
State	:	IA
Zip	:	51104
Country	:	US
Telephone Number	:	712-255-4204
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	CLARA TALIA PETERSON
Credential	:
Telephone Number	:	712-252-2477

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	12/19/2025

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