Provider Demographics
NPI:1588274302
Name:PEOPLE'S MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:PEOPLE'S MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:WADE
Authorized Official - Middle Name:E
Authorized Official - Last Name:WEIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-332-0999
Mailing Address - Street 1:2405 ROCK ISLAND RD
Mailing Address - Street 2:
Mailing Address - City:OELWEIN
Mailing Address - State:IA
Mailing Address - Zip Code:50662-3102
Mailing Address - Country:US
Mailing Address - Phone:319-283-1664
Mailing Address - Fax:319-283-1774
Practice Address - Street 1:2405 ROCK ISLAND RD
Practice Address - Street 2:
Practice Address - City:OELWEIN
Practice Address - State:IA
Practice Address - Zip Code:50662-3102
Practice Address - Country:US
Practice Address - Phone:319-283-1664
Practice Address - Fax:319-283-1774
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEOPLE'S MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-06
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0002XSuppliersPharmacyClinic Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy