Provider Demographics
NPI:1427015585
Name:GRUNDY COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:GRUNDY COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZINKULA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-824-5082
Mailing Address - Street 1:201 E J AVE
Mailing Address - Street 2:
Mailing Address - City:GRUNDY CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50638-2096
Mailing Address - Country:US
Mailing Address - Phone:319-824-5421
Mailing Address - Fax:319-824-6291
Practice Address - Street 1:201 E J AVE
Practice Address - Street 2:
Practice Address - City:GRUNDY CENTER
Practice Address - State:IA
Practice Address - Zip Code:50638-2096
Practice Address - Country:US
Practice Address - Phone:319-824-5421
Practice Address - Fax:319-824-6291
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRUNDY COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-01
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA380114H275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0655134Medicaid
IA0655134Medicaid