Provider Demographics
NPI:1063475127
Name:DELAWARE COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:DELAWARE COUNTY MEMORIAL HOSPITAL
Other - Org Name:REGIONAL MEDICAL HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:DANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-927-3232
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-0359
Mailing Address - Country:US
Mailing Address - Phone:563-927-7303
Mailing Address - Fax:563-927-7444
Practice Address - Street 1:613 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:IA
Practice Address - Zip Code:52057-1527
Practice Address - Country:US
Practice Address - Phone:563-927-7303
Practice Address - Fax:563-927-7444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-10
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA67156OtherBCIA
IA0293324Medicaid
IA0671560Medicaid
IA167156Medicare Oscar/Certification