Provider Demographics
NPI:1003886110
Name:MAHASKA COUNTY HOSPITAL
Entity Type:Organization
Organization Name:MAHASKA COUNTY HOSPITAL
Other - Org Name:MAHASKA HEALTH PARTNERSHIP HOSPICE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:W
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-672-3132
Mailing Address - Street 1:1229 C AVE E
Mailing Address - Street 2:
Mailing Address - City:OSKALOOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52577-4298
Mailing Address - Country:US
Mailing Address - Phone:641-672-3260
Mailing Address - Fax:641-372-3490
Practice Address - Street 1:1229 C AVE E
Practice Address - Street 2:
Practice Address - City:OSKALOOSA
Practice Address - State:IA
Practice Address - Zip Code:52577-4298
Practice Address - Country:US
Practice Address - Phone:641-672-3274
Practice Address - Fax:641-372-3490
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAHASKA COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-23
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA161511Medicare Oscar/Certification