Provider Demographics
NPI:1699856260
Name:ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA
Entity Type:Organization
Organization Name:ALEGENT HEALTH - MERCY HOSPITAL, CORNING IOWA
Other - Org Name:CHI HEALTH MERCY CORNING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO - CHI HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:EVERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-343-4420
Mailing Address - Street 1:PO BOX 776207
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6207
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:603 ROSARY DR
Practice Address - Street 2:
Practice Address - City:CORNING
Practice Address - State:IA
Practice Address - Zip Code:50841-1683
Practice Address - Country:US
Practice Address - Phone:641-322-6278
Practice Address - Fax:641-322-3389
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QA1903X
IA020170H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
161304Medicare Oscar/Certification