Provider Demographics
NPI:1952319840
Name:KNOXVILLE COMMUNITY HOSPITAL INC
Entity type:Organization
Organization Name:KNOXVILLE COMMUNITY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:KINCAID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-842-1400
Mailing Address - Street 1:1002 S LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:50138-3155
Mailing Address - Country:US
Mailing Address - Phone:641-842-2151
Mailing Address - Fax:641-842-1470
Practice Address - Street 1:1002 S LINCOLN ST
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:IA
Practice Address - Zip Code:50138-3155
Practice Address - Country:US
Practice Address - Phone:641-842-2151
Practice Address - Fax:641-842-1470
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KNOXVILLE COMMUNITY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-04
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA630031H282NC0060X, 275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA66114OtherWELLMARK BLUE CROSS IOWA
IA66114OtherWELLMARK BLUE CROSS IOWA