Provider Demographics
NPI:1578600961
Name:CENTRAL COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:CENTRAL COMMUNITY HOSPITAL
Other - Org Name:MERCYONE ELKADER MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KENSINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-245-7085
Mailing Address - Street 1:901 DAVIDSON ST NW
Mailing Address - Street 2:
Mailing Address - City:ELKADER
Mailing Address - State:IA
Mailing Address - Zip Code:52043-9015
Mailing Address - Country:US
Mailing Address - Phone:563-245-7000
Mailing Address - Fax:563-245-7080
Practice Address - Street 1:901 DAVIDSON ST NW
Practice Address - Street 2:
Practice Address - City:ELKADER
Practice Address - State:IA
Practice Address - Zip Code:52043-9015
Practice Address - Country:US
Practice Address - Phone:563-245-7000
Practice Address - Fax:563-245-7080
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-01
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1421Medicare PIN