Provider Demographics
NPI:1316063076
Name:VAN BUREN COUNTY HOSPITAL
Entity type:Organization
Organization Name:VAN BUREN COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:KARA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MCENTEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-293-3171
Mailing Address - Street 1:304 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:KEOSAUQUA
Mailing Address - State:IA
Mailing Address - Zip Code:52565-1164
Mailing Address - Country:US
Mailing Address - Phone:319-293-3171
Mailing Address - Fax:319-293-6241
Practice Address - Street 1:304 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:KEOSAUQUA
Practice Address - State:IA
Practice Address - Zip Code:52565-1164
Practice Address - Country:US
Practice Address - Phone:319-293-3171
Practice Address - Fax:319-293-6241
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAN BUREN COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-22
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0131680Medicaid
IA52213Medicare PIN