Basic Information
| Provider Information | |||||||||
| NPI: | 1952486433 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALEGENT HEALTH - MERCY HOSPITAL, CORNING, IOWA | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | CHI HEALTH CLINIC CORNING | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ROSARY DR | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | IA | ||||||||
| PostalCode: | 508411683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413225245 | ||||||||
| FaxNumber: | 6413224687 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 ROSARY DR | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | IA | ||||||||
| PostalCode: | 508411683 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6413225245 | ||||||||
| FaxNumber: | 6413224687 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2006 | ||||||||
| LastUpdateDate: | 02/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | KUIPER | ||||||||
| AuthorizedOfficialFirstName: | EVERT | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | CEO - CHI HEALTH | ||||||||
| AuthorizedOfficialTelephone: | 4023434420 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 02/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QR1300X | 023480 | IA | Y | Ambulatory Health Care Facilities | Clinic/Center | Rural Health |
No ID Information.