Provider Demographics
NPI:1598924623
Name:BURGESS HEALTH CENTER
Entity Type:Organization
Organization Name:BURGESS HEALTH CENTER
Other - Org Name:BHC AMBULANCE
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:TRAMP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-423-2311
Mailing Address - Street 1:1600 DIAMOND ST
Mailing Address - Street 2:
Mailing Address - City:ONAWA
Mailing Address - State:IA
Mailing Address - Zip Code:51040-1548
Mailing Address - Country:US
Mailing Address - Phone:712-423-2311
Mailing Address - Fax:712-423-3500
Practice Address - Street 1:1600 DIAMOND ST
Practice Address - Street 2:
Practice Address - City:ONAWA
Practice Address - State:IA
Practice Address - Zip Code:51040-1548
Practice Address - Country:US
Practice Address - Phone:712-423-2311
Practice Address - Fax:712-423-3500
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BURGESS HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0111294Medicaid