# WAYNE COUNTY HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LINEVILLE MEDICAL CLINIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487746764
- **Authorized official:** SUSAN HENDERSON (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (641) 872-5341

## Contact information

- **Practice address:** 101 MAIN ST, LINEVILLE, IA 50147-8517
- **Practice address phone:** (641) 876-2070
- **Practice address fax:** (641) 876-2458
- **Mailing address:** PO BOX 283, CORYDON, IA 50060-0283

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/28/2006
- **Last updated:** 12/30/2016