Organization
ELLSWORTH MUNICIPAL HOSPITAL
Active
Other names
ELLSWORTH FAMILY MEDICINE-HUBBARD
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL WHITE (CEO)
(641) 648-4631
Entity
Organization
Contact information
Practice address
324 EAST MAPLE STREET, HUBBARD, IA 50122-0487
(641) 648-3202
(641) 648-3203
Mailing address
324 EAST MAPLE STREET, PO BOX 487, HUBBARD, IA 50122-0487
(641) 648-3202
(641) 648-3203
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
18633
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2129163
—
IA
01
—
I15574
MEDICARE GROUP
IA
01
—
I15576
MEDICARE
IA
Enumeration date
12/17/2007
Last updated
12/03/2020
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