Organization
CRAWFORD COUNTY MEMORIAL HOSPITAL
Active
Parent organization
CRAWFORD COUNTY MEMORIAL HOSPITAL
Other names
CCMH Medical Clinic - City Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
CRAWFORD COUNTY MEMORIAL HOSPITAL
Authorized official
MR. BILLY J BRUCE (CHIEF EXECUTIVE OFFICER)
(712) 265-2502
Entity
Organization
Contact information
Practice address
115 N 14TH ST, DENISON, IA 51442-1452
(712) 263-5071
(712) 263-6106
Mailing address
115 N 14TH ST, DENISON, IA 51442-1452
(712) 263-5071
(712) 263-6106
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
240173H
IA
364SF0001X
Family Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1134586811
NPI
IA
05
—
1134586811
—
IA
Enumeration date
01/26/2016
Last updated
04/18/2017
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