Provider Demographics
NPI:1083767321
Name:HAMILTON COUNTY PUBLIC HOSPITAL
Entity Type:Organization
Organization Name:HAMILTON COUNTY PUBLIC HOSPITAL
Other - Org Name:VAN DIEST MEDICAL CENTER AMBULANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:515-832-7751
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-0430
Mailing Address - Country:US
Mailing Address - Phone:515-832-9400
Mailing Address - Fax:515-832-9420
Practice Address - Street 1:2350 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:WEBSTER CITY
Practice Address - State:IA
Practice Address - Zip Code:50595-6600
Practice Address - Country:US
Practice Address - Phone:515-832-9400
Practice Address - Fax:515-832-9420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMILTON COUNTY PUBLIC HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-19
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA400120H3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0068767Medicaid