Provider Demographics
NPI:1962572776
Name:PALO ALTO COUNTY HOSPITAL
Entity type:Organization
Organization Name:PALO ALTO COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EINSWEILER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-852-5500
Mailing Address - Street 1:3201 1ST ST
Mailing Address - Street 2:
Mailing Address - City:EMMETSBURG
Mailing Address - State:IA
Mailing Address - Zip Code:50536-2516
Mailing Address - Country:US
Mailing Address - Phone:712-852-5500
Mailing Address - Fax:712-852-5409
Practice Address - Street 1:107 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:IA
Practice Address - Zip Code:50597-7738
Practice Address - Country:US
Practice Address - Phone:515-887-7891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0634840Medicaid
IA63417OtherWELLMARK
IA163417Medicare Oscar/Certification