Provider Demographics
NPI:1861785446
Name:SIOUX CENTER COMMUNITY HOSPITAL AND HEALTH CENTER
Entity type:Organization
Organization Name:SIOUX CENTER COMMUNITY HOSPITAL AND HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, CLINIC OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCLUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-722-2609
Mailing Address - Street 1:645 S MAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX CENTER
Mailing Address - State:IA
Mailing Address - Zip Code:51250-1347
Mailing Address - Country:US
Mailing Address - Phone:712-722-2609
Mailing Address - Fax:712-722-4325
Practice Address - Street 1:255 16TH ST SW
Practice Address - Street 2:
Practice Address - City:SIOUX CENTER
Practice Address - State:IA
Practice Address - Zip Code:51250-2959
Practice Address - Country:US
Practice Address - Phone:712-722-5194
Practice Address - Fax:712-722-5196
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SIOUX CENTER COMMUNITY HOSPITAL AND HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-16
Last Update Date:2013-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA31210207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty