Provider Demographics
NPI:1023025137
Name:KNOXVILLE COMMUNITY HOSPITAL, INC.
Entity Type:Organization
Organization Name:KNOXVILLE COMMUNITY HOSPITAL, INC.
Other - Org Name:KNOXVILLE HOSPITAL & CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:MARGARET
Authorized Official - Last Name:HELWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-842-2151
Mailing Address - Street 1:1002 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3121
Mailing Address - Country:US
Mailing Address - Phone:641-842-2151
Mailing Address - Fax:641-842-1470
Practice Address - Street 1:104 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:IA
Practice Address - Zip Code:50225
Practice Address - Country:US
Practice Address - Phone:515-848-3113
Practice Address - Fax:515-848-5257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-02
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA630031H207Q00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA39112OtherWELLMARK BC&BSIA
IA0433995Medicaid
IAI12087Medicare ID - Type Unspecified