Provider Demographics
NPI:1043511850
Name:GRINNELL REGIONAL MEDICAL CENTER
Entity type:Organization
Organization Name:GRINNELL REGIONAL MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RURAL PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID-PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CAVAZOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:641-236-7511
Mailing Address - Street 1:210 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:GRINNELL
Mailing Address - State:IA
Mailing Address - Zip Code:50112-1898
Mailing Address - Country:US
Mailing Address - Phone:641-236-2934
Mailing Address - Fax:641-236-2599
Practice Address - Street 1:306 4TH AVE
Practice Address - Street 2:
Practice Address - City:GRINNELL
Practice Address - State:IA
Practice Address - Zip Code:50112-1803
Practice Address - Country:US
Practice Address - Phone:641-236-2385
Practice Address - Fax:641-236-2599
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GRINNELL REGIONAL MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-11-10
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health