Provider Demographics
NPI:1851308423
Name:HAMILTON COUNTY PUBLIC HOSPITAL
Entity Type:Organization
Organization Name:HAMILTON COUNTY PUBLIC HOSPITAL
Other - Org Name:VAN DIEST MEDICAL CENTER JEWELL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEINRICHS
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:515-832-9400
Mailing Address - Street 1:PO BOX 430
Mailing Address - Street 2:
Mailing Address - City:WEBSTER CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50595-0430
Mailing Address - Country:US
Mailing Address - Phone:515-832-9400
Mailing Address - Fax:515-832-9420
Practice Address - Street 1:731 MAIN ST
Practice Address - Street 2:
Practice Address - City:JEWELL
Practice Address - State:IA
Practice Address - Zip Code:50130-2040
Practice Address - Country:US
Practice Address - Phone:515-827-6175
Practice Address - Fax:515-827-6189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAMILTON COUNTY PUBLIC HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-03
Last Update Date:2017-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA35739OtherBLUE CROSS
03253Medicare ID - Type Unspecified