Provider Demographics
NPI:1548364813
Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Entity type:Organization
Organization Name:REGIONAL HEALTH SERVICES OF HOWARD COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EFO
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:BURKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-547-2022
Mailing Address - Street 1:235 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:CRESCO
Mailing Address - State:IA
Mailing Address - Zip Code:52136-1062
Mailing Address - Country:US
Mailing Address - Phone:563-547-2101
Mailing Address - Fax:563-547-3448
Practice Address - Street 1:402 2ND AVE SE
Practice Address - Street 2:
Practice Address - City:CRESCO
Practice Address - State:IA
Practice Address - Zip Code:52136-1816
Practice Address - Country:US
Practice Address - Phone:563-547-2989
Practice Address - Fax:563-547-4223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA450057H251G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0615658Medicaid
IA61551OtherBLUE CROSS
IA61551OtherBLUE CROSS