Provider Demographics
NPI:1992854434
Name:RINGGOLD COUNTY HOSPITAL
Entity Type:Organization
Organization Name:RINGGOLD COUNTY HOSPITAL
Other - Org Name:MOUNT AYR MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-464-3226
Mailing Address - Street 1:504 N. CLEVELAND ST.
Mailing Address - Street 2:
Mailing Address - City:MOUNT AYR
Mailing Address - State:IA
Mailing Address - Zip Code:50854-2201
Mailing Address - Country:US
Mailing Address - Phone:641-464-3226
Mailing Address - Fax:641-464-4420
Practice Address - Street 1:504 N. CLEVELAND ST.
Practice Address - Street 2:
Practice Address - City:MOUNT AYR
Practice Address - State:IA
Practice Address - Zip Code:50854-2201
Practice Address - Country:US
Practice Address - Phone:641-464-3226
Practice Address - Fax:641-464-4420
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RINGGOLD COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-10
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA800167H261QC0050X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC0050XAmbulatory Health Care FacilitiesClinic/CenterCritical Access Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
IACE8169OtherRAILROAD
IAA5085401OtherJOHN DEERE
ND13869Medicaid
IA50482OtherBLUE CROSS
IA0146233Medicaid
IA1600486Medicaid
MO500671706Medicaid