Provider Demographics
NPI:1962635615
Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:IDA COUNTY IOWA COMMUNITY HOSPITAL
Other - Org Name:HORN PHYSICIANS CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:JONI
Authorized Official - Middle Name:G
Authorized Official - Last Name:SCHUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-364-7225
Mailing Address - Street 1:701 EAST 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:IDA GROVE
Mailing Address - State:IA
Mailing Address - Zip Code:51445-1699
Mailing Address - Country:US
Mailing Address - Phone:712-364-3311
Mailing Address - Fax:712-364-3363
Practice Address - Street 1:700 E 2ND ST
Practice Address - Street 2:SUITE 2
Practice Address - City:IDA GROVE
Practice Address - State:IA
Practice Address - Zip Code:51445-1601
Practice Address - Country:US
Practice Address - Phone:712-364-2514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IDA COUNTY IOWA COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-08-28
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAIB1500Medicare PIN