Provider Demographics
NPI:1407107923
Name:SIOUX CENTER HEALTH
Entity Type:Organization
Organization Name:SIOUX CENTER HEALTH
Other - Org Name:SIOUX CENTER MEDICAL CLINIC GENERAL SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CRYSTAL
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-8153
Mailing Address - Street 1:1101 9 ST SE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-2501
Mailing Address - Country:US
Mailing Address - Phone:712-722-2609
Mailing Address - Fax:712-722-8426
Practice Address - Street 1:1101 9 ST SE
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-2501
Practice Address - Country:US
Practice Address - Phone:712-722-2609
Practice Address - Fax:712-722-8426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIOUX CENTER HEALTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-09-24
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty