Organization
COMMUNITY HEALTH CENTER OF FORT DODGE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RENAE IRENE ELIZABETH KRUCKENBERG (CEO)
(515) 576-6500
Entity
Organization
Contact information
Practice address
126 NORTH 10TH ST, FORT DODGE, IA 50501-3915
(515) 576-6500
(515) 576-2021
Mailing address
126 NORTH 10TH ST, FORT DODGE, IA 50501-3915
(515) 576-6500
(515) 576-1951
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
IA
Other
Enumeration date
05/23/2006
Last updated
03/01/2023
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