Organization
ALLEN MEMORIAL HOSPITAL CORPORATION
Active
Other names
Allen Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAMELA K. DELAGARDELLE (PRESIDENT/CEO)
(319) 235-3987
Entity
Organization
Contact information
Practice address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3941
Mailing address
1825 LOGAN AVE, WATERLOO, IA 50703-1916
(319) 235-3941
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
—
—
207P00000X
Emergency Medicine Physician
Primary
—
—
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
—
—
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0170142
—
IA
01
—
0401143
MEDICAID - NP GROUP
IA
01
—
17014
WELLMARK BCBS/IOWA
IA
Enumeration date
05/16/2006
Last updated
11/08/2016
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