Provider Demographics
NPI:1790251924
Name:SPENCER MUNICIPAL HOSPITAL
Entity Type:Organization
Organization Name:SPENCER MUNICIPAL HOSPITAL
Other - Org Name:REHAB @ THE CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TIEFENTHALER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-264-6111
Mailing Address - Street 1:1200 1ST AVE E
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:IA
Mailing Address - Zip Code:51301-4330
Mailing Address - Country:US
Mailing Address - Phone:712-264-6111
Mailing Address - Fax:712-264-6404
Practice Address - Street 1:116 E 11TH ST STE 208
Practice Address - Street 2:
Practice Address - City:SPENCER
Practice Address - State:IA
Practice Address - Zip Code:51301-4363
Practice Address - Country:US
Practice Address - Phone:712-264-6189
Practice Address - Fax:712-264-6542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-15
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center