Provider Demographics
NPI:1184645434
Name:CENTRAL COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:CENTRAL COMMUNITY HOSPITAL
Other - Org Name:MERCYONE ELKADER MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KENSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-245-7085
Mailing Address - Street 1:901 DAVIDSON STREET NW
Mailing Address - Street 2:
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-9015
Mailing Address - Country:US
Mailing Address - Phone:563-245-7000
Mailing Address - Fax:563-245-7080
Practice Address - Street 1:901 DAVIDSON STREET NW
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9015
Practice Address - Country:US
Practice Address - Phone:563-245-7000
Practice Address - Fax:563-245-7080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA220051H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0600635Medicaid
IA161319Medicare Oscar/Certification