Provider Demographics
NPI:1306969175
Name:MANNING REGIONAL HEALTHCARE CENTER
Entity type:Organization
Organization Name:MANNING REGIONAL HEALTHCARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:O'BRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1712-655-2072
Mailing Address - Street 1:1550 6TH ST
Mailing Address - Street 2:
Mailing Address - City:MANNING
Mailing Address - State:IA
Mailing Address - Zip Code:51455-1004
Mailing Address - Country:US
Mailing Address - Phone:712-655-2072
Mailing Address - Fax:712-655-3330
Practice Address - Street 1:1550 6TH ST
Practice Address - Street 2:
Practice Address - City:MANNING
Practice Address - State:IA
Practice Address - Zip Code:51455-1004
Practice Address - Country:US
Practice Address - Phone:712-655-2072
Practice Address - Fax:712-655-3330
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MANNING REGIONAL HEALTHCARE CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-09
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA41512OtherBLUE CROSS RADIOLOGY #
IA40538OtherBLUE CROSS ER DR #
IA0146332Medicaid
IA71972Medicare PIN