Provider Demographics
NPI:1720280928
Name:COMMUNITY HOSP
Entity Type:Organization
Organization Name:COMMUNITY HOSP
Other - Org Name:HAWARDEN COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:PERCY
Authorized Official - Last Name:MARKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:712-551-3103
Mailing Address - Street 1:1111 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWARDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51023
Mailing Address - Country:US
Mailing Address - Phone:712-551-3100
Mailing Address - Fax:
Practice Address - Street 1:1111 11TH ST
Practice Address - Street 2:
Practice Address - City:HAWARDEN
Practice Address - State:IA
Practice Address - Zip Code:51023-1903
Practice Address - Country:US
Practice Address - Phone:712-551-3100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-01
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0165126OtherELDERLY WAIVER