Organization
BUENA VISTA REGIONAL MEDICAL CENTER
Active
Parent organization
BUENA VISTA REGIONAL MEDICAL CENTER
Other names
Buena Vista Regional Medical Center Homecare
Organization subpart
Yes
Provider details
NPI number
Legal business name
BUENA VISTA REGIONAL MEDICAL CENTER
Authorized official
MRS. KRISTA L KETCHAM (CFO)
(712) 213-1233
Entity
Organization
Contact information
Practice address
1305 W MILWAUKEE AVE, STORM LAKE, IA 50588-2904
(712) 749-2741
(712) 749-2750
Mailing address
PO BOX 309, STORM LAKE, IA 50588-0309
(712) 732-4030
(712) 213-1233
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0671800
—
IA
01
—
67180
WELLMARK
IA
Enumeration date
05/09/2006
Last updated
07/08/2011
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