Provider Demographics
NPI:1285715870
Name:ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA
Entity type:Organization
Organization Name:ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO - CHI HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:EVERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-343-4420
Mailing Address - Street 1:210 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:IA
Mailing Address - Zip Code:50851-1242
Mailing Address - Country:US
Mailing Address - Phone:641-333-2266
Mailing Address - Fax:641-333-2231
Practice Address - Street 1:210 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:IA
Practice Address - Zip Code:50851-1242
Practice Address - Country:US
Practice Address - Phone:641-333-2266
Practice Address - Fax:641-333-2231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA873478261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
163478Medicare Oscar/Certification
163478Medicare ID - Type Unspecified