Provider Demographics
NPI:1720099831
Name:PALO ALTO COUNTY HOSPITAL
Entity Type:Organization
Organization Name:PALO ALTO COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EINSWEILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-852-5500
Mailing Address - Street 1:3201 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-2516
Mailing Address - Country:US
Mailing Address - Phone:712-852-5500
Mailing Address - Fax:712-852-5508
Practice Address - Street 1:3201 1ST ST
Practice Address - Street 2:
Practice Address - City:EMMETSBURG
Practice Address - State:IA
Practice Address - Zip Code:50536-2516
Practice Address - Country:US
Practice Address - Phone:712-852-5500
Practice Address - Fax:712-852-5508
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PALO ALTO COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-11
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA740045H275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA66118OtherBLUECROSS SKILLED PROV.#
IA0655027Medicaid
IA0655027Medicaid