Organization
BUENA VISTA REGIONAL MEDICAL CENTER
Active
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
PO BOX 309, STORM LAKE, IA 50588-0309
(712) 732-4030
(712) 213-1233
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
110166H
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0600668
—
IA
01
—
60066
WELLMARK PROVIDER NUMBER
IA
Enumeration date
02/07/2006
Last updated
07/08/2011
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