Provider Demographics
NPI:1548923253
Name:PELLA REGIONAL HEALTH CENTER
Entity type:Organization
Organization Name:PELLA REGIONAL HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:KROESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-628-6604
Mailing Address - Street 1:2525 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PELLA
Mailing Address - State:IA
Mailing Address - Zip Code:50219-1553
Mailing Address - Country:US
Mailing Address - Phone:641-628-6728
Mailing Address - Fax:641-628-6727
Practice Address - Street 1:2525 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:PELLA
Practice Address - State:IA
Practice Address - Zip Code:50219-1553
Practice Address - Country:US
Practice Address - Phone:641-628-6728
Practice Address - Fax:641-628-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation