Provider Demographics
NPI:1790906642
Name:VAN BUREN COUNTY HOSPITAL
Entity Type:Organization
Organization Name:VAN BUREN COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-293-3171
Mailing Address - Street 1:304 FRANKLIN STREET
Mailing Address - Street 2:PO BOX 70
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-1164
Mailing Address - Country:US
Mailing Address - Phone:319-293-3171
Mailing Address - Fax:
Practice Address - Street 1:304 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-1164
Practice Address - Country:US
Practice Address - Phone:319-293-3171
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0168807Medicaid
IA0796600001Medicare NSC