Provider Demographics
NPI:1477127728
Name:KEOKUK AREA HOSPITAL
Entity Type:Organization
Organization Name:KEOKUK AREA HOSPITAL
Other - Org Name:BLESSING HEALTH KEOKUK CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:RENEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-526-8772
Mailing Address - Street 1:1414 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3926
Mailing Address - Country:US
Mailing Address - Phone:319-524-0123
Mailing Address - Fax:
Practice Address - Street 1:1414 MAIN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3926
Practice Address - Country:US
Practice Address - Phone:319-524-0123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEOKUK AREA HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-05-19
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health