Provider Demographics
NPI:1679158737
Name:CENTRAL COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:CENTRAL COMMUNITY HOSPITAL
Other - Org Name:MERCYONE MONONA FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BROOKE
Authorized Official - Middle Name:
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 1:101 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MONONA
Practice Address - State:IA
Practice Address - Zip Code:52159-8092
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:2021-03-10
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health