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Organization
BUENA VISTA REGIONAL MEDICAL CENTER
Active
Organization
BUENA VISTA REGIONAL MEDICAL CENTER
Active
Other names
ER Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTA L KETCHAM (CFO)
(712) 213-8603
Entity
Organization
Contact information
Practice address
1525 W 5TH ST, STORM LAKE, IA 50588-3027
(712) 732-4030
(712) 213-1233
Mailing address
1525 W 5TH ST, PO BOX 309, STORM LAKE, IA 50588-3027
(712) 732-4030
(712) 213-1233
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
166H
IA
Other
Enumeration date
11/13/2006
Last updated
07/08/2011
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