Provider Demographics
NPI:1003398835
Name:ELLSWORTH MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:ELLSWORTH MUNICIPAL HOSPITAL
Other - Org Name:NESCO FAMILY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:MORSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-648-7010
Mailing Address - Street 1:920 S OAK ST
Mailing Address - Street 2:
Mailing Address - City:IOWA FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50126-9506
Mailing Address - Country:US
Mailing Address - Phone:641-648-7132
Mailing Address - Fax:
Practice Address - Street 1:112 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ZEARING
Practice Address - State:IA
Practice Address - Zip Code:50278-7728
Practice Address - Country:US
Practice Address - Phone:641-487-7800
Practice Address - Fax:641-487-7803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-29
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty