Provider Demographics
NPI:1962654921
Name:GUTHRIE COUNTY HOSPITAL
Entity Type:Organization
Organization Name:GUTHRIE COUNTY HOSPITAL
Other - Org Name:GCH CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:STIPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-332-2201
Mailing Address - Street 1:710 N 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:50115-1549
Mailing Address - Country:US
Mailing Address - Phone:641-332-2201
Mailing Address - Fax:641-332-2702
Practice Address - Street 1:103 SE 13TH ST
Practice Address - Street 2:
Practice Address - City:PANORA
Practice Address - State:IA
Practice Address - Zip Code:50216-4500
Practice Address - Country:US
Practice Address - Phone:641-755-4000
Practice Address - Fax:641-755-3541
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GUTHRIE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-21
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA28764207Q00000X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1074322Medicaid
IA1074322Medicaid