Provider Demographics
NPI:1497862981
Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Other - Org Name:HORN MEMORIAL HOSPITAL CARDIOGRAPHERS
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JONI
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-364-3311
Mailing Address - Street 1:701 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:IDA GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:51445-1699
Mailing Address - Country:US
Mailing Address - Phone:712-364-3311
Mailing Address - Fax:
Practice Address - Street 1:701 E 2ND ST
Practice Address - Street 2:
Practice Address - City:IDA GROVE
Practice Address - State:IA
Practice Address - Zip Code:51445-1699
Practice Address - Country:US
Practice Address - Phone:712-364-3311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA31633OtherBLUE CROSS
IA8146969Medicaid
IA31633Medicare ID - Type Unspecified