Provider Demographics
NPI:1982691002
Name:HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:HENRY COUNTY SOLDIERS' AND SAILORS' MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER-FINANCE
Authorized Official - Prefix:
Authorized Official - First Name:BRANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS-LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-385-6529
Mailing Address - Street 1:407 S WHITE ST
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:IA
Mailing Address - Zip Code:52641-2263
Mailing Address - Country:US
Mailing Address - Phone:319-385-3141
Mailing Address - Fax:319-385-6571
Practice Address - Street 1:401 S VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:IA
Practice Address - Zip Code:52641-2232
Practice Address - Country:US
Practice Address - Phone:319-385-5350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HENRY COUNTY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-10-04
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0801829Medicaid
IA65147OtherWELLMARK BC OF IA
IA0801829Medicaid