Provider Demographics
NPI:1386719748
Name:IOWA SPECIALTY HOSPITAL - CLARION
Entity type:Organization
Organization Name:IOWA SPECIALTY HOSPITAL - CLARION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMINON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:515-532-9333
Mailing Address - Street 1:215 13TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:CLARION
Mailing Address - State:IA
Mailing Address - Zip Code:50525-2078
Mailing Address - Country:US
Mailing Address - Phone:515-532-2801
Mailing Address - Fax:515-532-9321
Practice Address - Street 1:215 13TH AVE SW
Practice Address - Street 2:
Practice Address - City:CLARION
Practice Address - State:IA
Practice Address - Zip Code:50525-2078
Practice Address - Country:US
Practice Address - Phone:515-532-2801
Practice Address - Fax:515-532-9321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA3623336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0170126Medicaid
IA0381980001OtherPTAN