Provider Demographics
NPI:1588628804
Name:JACKSON COUNTY PUBLIC HOSPITAL
Entity Type:Organization
Organization Name:JACKSON COUNTY PUBLIC HOSPITAL
Other - Org Name:JACKSON COUNTY REGIONAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:M
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-652-4020
Mailing Address - Street 1:601 HOSPITAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:MAQUOKETA
Mailing Address - State:IA
Mailing Address - Zip Code:52060-0910
Mailing Address - Country:US
Mailing Address - Phone:563-652-2474
Mailing Address - Fax:563-652-4096
Practice Address - Street 1:601 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:MAQUOKETA
Practice Address - State:IA
Practice Address - Zip Code:52060-0910
Practice Address - Country:US
Practice Address - Phone:563-652-2474
Practice Address - Fax:563-652-4096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA490099H332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies