Provider Demographics
NPI:1366081358
Name:FORT MADISON COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:FORT MADISON COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:BARB
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LINDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-376-2711
Mailing Address - Street 1:PO BOX 174
Mailing Address - Street 2:
Mailing Address - City:FORT MADISON
Mailing Address - State:IA
Mailing Address - Zip Code:52627-0174
Mailing Address - Country:US
Mailing Address - Phone:319-372-6530
Mailing Address - Fax:
Practice Address - Street 1:5445 AVENUE O
Practice Address - Street 2:
Practice Address - City:FORT MADISON
Practice Address - State:IA
Practice Address - Zip Code:52627-9611
Practice Address - Country:US
Practice Address - Phone:319-372-6530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FORT MADISON COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-23
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric PsychiatryGroup - Single Specialty