Provider Demographics
NPI:1467509141
Name:MANNING REGIONAL HEALTHCARE CENTER
Entity Type:Organization
Organization Name:MANNING REGIONAL HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:L
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-655-2072
Mailing Address - Street 1:1550 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1004
Mailing Address - Country:US
Mailing Address - Phone:712-655-2072
Mailing Address - Fax:712-655-3330
Practice Address - Street 1:1550 6TH ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1004
Practice Address - Country:US
Practice Address - Phone:712-655-2072
Practice Address - Fax:712-655-3330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA140058H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0601112Medicaid
IAKZ10MVOtherNEW EDC LOG ON ID
IA161332Medicare Oscar/Certification