Provider Demographics
NPI:1316927445
Name:ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Entity type:Organization
Organization Name:ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:SALMONSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-794-5424
Mailing Address - Street 1:311 S CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CARROLL
Mailing Address - State:IA
Mailing Address - Zip Code:51401-3038
Mailing Address - Country:US
Mailing Address - Phone:712-792-3581
Mailing Address - Fax:712-792-2124
Practice Address - Street 1:1820 4TH AVE S
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:IA
Practice Address - Zip Code:51442-2139
Practice Address - Country:US
Practice Address - Phone:712-263-6116
Practice Address - Fax:712-263-6115
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST ANTHONY REGIONAL HOSPITAL AND NURSING HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-01-17
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA140090H208D00000X
261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
163400OtherMEDICARE OSCAR
IA163400Medicare Oscar/Certification