Provider Demographics
NPI:1467422725
Name:ORANGE CITY MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:ORANGE CITY MUNICIPAL HOSPITAL
Other - Org Name:ORANGE CITY LONG TERM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:W
Authorized Official - Last Name:GUTHMILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-737-4984
Mailing Address - Street 1:1000 LINCOLN CIR SE
Mailing Address - Street 2:
Mailing Address - City:ORANGE CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51041-1862
Mailing Address - Country:US
Mailing Address - Phone:712-737-4984
Mailing Address - Fax:
Practice Address - Street 1:400 CENTRAL AVE NW
Practice Address - Street 2:LONG TERM CARE
Practice Address - City:ORANGE CITY
Practice Address - State:IA
Practice Address - Zip Code:51041-1342
Practice Address - Country:US
Practice Address - Phone:712-737-4984
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0807651Medicaid
IA0807651Medicaid