Organization
SUMNER COMMUNITY CLUB
Active
Other names
Community Memorial Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN DIANE EVERDING CFO (CHIEF FINANCIAL OFFICER)
(563) 578-3275
Entity
Organization
Contact information
Practice address
909 W 1ST ST, SUMNER, IA 50674-1203
(563) 578-3275
(563) 578-3279
Mailing address
PO BOX 148, SUMNER, IA 50674-0148
(563) 578-3275
(563) 578-3279
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
—
—
207P00000X
Emergency Medicine Physician
—
—
207Q00000X
Family Medicine Physician
—
—
282NC0060X
Critical Access Hospital
Primary
090086H
IA
363L00000X
Nurse Practitioner
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0601385
TITLE XIX
IA
01
—
60138
BLUE CROSS (ACUTE)
IA
01
—
6230725
AETNA
IA
01
—
A5067404
JOHN DEERE
IA
Enumeration date
07/22/2005
Last updated
07/31/2015
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