Provider Demographics
NPI:1215054713
Name:STORY COUNTY HOSPITAL
Entity type:Organization
Organization Name:STORY COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMTHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-382-2111
Mailing Address - Street 1:640 S 19TH ST
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:IA
Mailing Address - Zip Code:50201-2902
Mailing Address - Country:US
Mailing Address - Phone:515-382-2111
Mailing Address - Fax:515-382-7760
Practice Address - Street 1:640 S 19TH ST
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:IA
Practice Address - Zip Code:50201-2902
Practice Address - Country:US
Practice Address - Phone:515-382-2111
Practice Address - Fax:515-382-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2017-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA850174H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0048199Medicaid
IA66088OtherBC-BS IA SWING PROV#
IA01558OtherBC-BS IA CRNA GRP PROV#
IA60088OtherBC-BS IA PROVIDER #
IA0164681Medicaid
IA0803825Medicaid
IA18762OtherBC-BS ER PHY GRP PROV#
IA0187625Medicaid
IA0117218Medicaid
IA029473OtherHEALTH ALLIANCE PROV#
IA0600882Medicaid
IA0655282Medicaid
IA0117218Medicaid
IA0803825Medicaid
IA0164681Medicaid