Provider Demographics
NPI:1467967968
Name:KNOXVILLE COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:KNOXVILLE COMMUNITY HOSPITAL INC
Other - Org Name:RED ROCK HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-842-1401
Mailing Address - Street 1:1002 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3121
Mailing Address - Country:US
Mailing Address - Phone:641-842-7056
Mailing Address - Fax:641-842-3791
Practice Address - Street 1:615 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1538
Practice Address - Country:US
Practice Address - Phone:641-628-2222
Practice Address - Fax:641-628-2915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-06
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA630031H207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0433995Medicaid
IA36313OtherWELLMARK BCBS IOWA