Provider Demographics
NPI:1689249922
Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:WINEKAUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-364-3311
Mailing Address - Street 1:701 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:IDA GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:51445-1699
Mailing Address - Country:US
Mailing Address - Phone:712-364-3311
Mailing Address - Fax:
Practice Address - Street 1:1400 S KIEL ST
Practice Address - Street 2:
Practice Address - City:HOLSTEIN
Practice Address - State:IA
Practice Address - Zip Code:51025-5091
Practice Address - Country:US
Practice Address - Phone:712-368-6300
Practice Address - Fax:712-368-6304
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IDA COUNTY IOWA COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-20
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health