Basic Information
| Provider Information | |||||||||
| NPI: | 1548923253 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PELLA REGIONAL HEALTH CENTER | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2525 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | PELLA | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502191553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6416286728 | ||||||||
| FaxNumber: | 6416286727 | ||||||||
| Practice Location | |||||||||
| Address1: | 2525 WASHINGTON ST | ||||||||
| Address2: | |||||||||
| City: | PELLA | ||||||||
| State: | IA | ||||||||
| PostalCode: | 502191553 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6416286728 | ||||||||
| FaxNumber: | 6416286727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/19/2021 | ||||||||
| LastUpdateDate: | 10/19/2021 | ||||||||
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| AuthorizedOfficialLastName: | KROESE | ||||||||
| AuthorizedOfficialFirstName: | ROBERT | ||||||||
| AuthorizedOfficialMiddleName: | D. | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6416286604 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 10/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation |
No ID Information.