Provider Demographics
NPI:1396792008
Name:IOWA SPECIALTY HOSPITAL- CLARION
Entity type:Organization
Organization Name:IOWA SPECIALTY HOSPITAL- CLARION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-532-9333
Mailing Address - Street 1:215 13TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2078
Mailing Address - Country:US
Mailing Address - Phone:515-532-2836
Mailing Address - Fax:515-532-2523
Practice Address - Street 1:215 13TH AVE SW
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2078
Practice Address - Country:US
Practice Address - Phone:515-532-2836
Practice Address - Fax:515-532-2523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA990177H261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0635011Medicaid
IAQ55137OtherM WHITEHILL-UPIN
IAA02773Medicare UPIN
IAI28108Medicare UPIN
IAQ55137OtherM WHITEHILL-UPIN
IAA02110Medicare UPIN
IAI13656Medicare UPIN
IAP31683Medicare UPIN
IAA01978Medicare UPIN
IA0635011Medicaid
IAA02356Medicare UPIN