Provider Demographics
NPI:1003479312
Name:HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBB
Authorized Official - Middle Name:M
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-385-6560
Mailing Address - Street 1:407 S WHITE ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2263
Mailing Address - Country:US
Mailing Address - Phone:319-385-3141
Mailing Address - Fax:319-385-6589
Practice Address - Street 1:111 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:IA
Practice Address - Zip Code:52645-1329
Practice Address - Country:US
Practice Address - Phone:319-367-2241
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health