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NPI Code Detail

MEDICARE: AVERA HOLY FAMILY

MEDICARE: AVERA HOLY FAMILY
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
1282NC0060XCritical Access Hospital320014HIA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
266002OTHERIAWELLMARK IA SWING BED

General Provider Information

NPI Number : 1891738365
Entity Type Code : Organization
Provider Name (Legal Business Name) : AVERA HOLY FAMILY
Provider Business Mailing Address
First Line : 826 N 8TH ST
Second Line :
City : ESTHERVILLE
State : IA
Zip : 51334-1528
Country : US
Telephone Number : 712-362-2631
Fax Number : 712-362-2636
Provider Business Practice Location Address
First Line : 826 N 8TH ST
Second Line :
City : ESTHERVILLE
State : IA
Zip : 51334-1528
Country : US
Telephone Number : 712-362-2631
Fax Number : 712-362-2636
Authorized Official
Title or Position : CEO
Name : DEB HERZBERG
Credential :
Telephone Number : 712-362-6160
Provider Enumeration Date : 06/13/2006
Last Update Date : 07/02/2021

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1124056338 — AVERA HOLY FAMILY
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51334-1528
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Directions to “AVERA HOLY FAMILY ” Practice Location

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