Provider Demographics
NPI:1326706664
Name:SIOUXLAND COMMUNITY HEALTH CENTER
Entity Type:Organization
Organization Name:SIOUXLAND COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:MAREE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:712-226-9013
Mailing Address - Street 1:1021 NEBRASKA ST
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51105-1436
Mailing Address - Country:US
Mailing Address - Phone:712-252-2477
Mailing Address - Fax:
Practice Address - Street 1:3410 FUTURES DR
Practice Address - Street 2:
Practice Address - City:SOUTH SIOUX CITY
Practice Address - State:NE
Practice Address - Zip Code:68776-3917
Practice Address - Country:US
Practice Address - Phone:712-252-2477
Practice Address - Fax:712-224-1895
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIOUXLAND COMMUNITY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy