Provider Demographics
NPI:1366486946
Name:CLARINDA REGIONAL HEALTH CENTER
Entity Type:Organization
Organization Name:CLARINDA REGIONAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:OTTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-542-2176
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:CLARINDA
Mailing Address - State:IA
Mailing Address - Zip Code:51632-2625
Mailing Address - Country:US
Mailing Address - Phone:712-542-2176
Mailing Address - Fax:
Practice Address - Street 1:220 ESSIE DAVISON DR
Practice Address - Street 2:
Practice Address - City:CLARINDA
Practice Address - State:IA
Practice Address - Zip Code:51632-2915
Practice Address - Country:US
Practice Address - Phone:712-542-2176
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA161352Medicare Oscar/Certification