Provider Demographics
NPI:1801060306
Name:HAWARDEN REGIONAL HEALTHCARE CLINICS LLC
Entity type:Organization
Organization Name:HAWARDEN REGIONAL HEALTHCARE CLINICS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:P
Authorized Official - Last Name:PULLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-551-3103
Mailing Address - Street 1:1122 12TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWARDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51023-1900
Mailing Address - Country:US
Mailing Address - Phone:712-551-3400
Mailing Address - Fax:712-551-2691
Practice Address - Street 1:318 MAIN ST
Practice Address - Street 2:
Practice Address - City:IRETON
Practice Address - State:IA
Practice Address - Zip Code:51027-7794
Practice Address - Country:US
Practice Address - Phone:712-278-1011
Practice Address - Fax:712-551-2691
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty