Provider Demographics
NPI:1487289955
Name:HAWARDEN REGIONAL HEALTHCARE
Entity type:Organization
Organization Name:HAWARDEN REGIONAL HEALTHCARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAYSON
Authorized Official - Middle Name:
Authorized Official - Last Name:PULLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-551-3100
Mailing Address - Street 1:1111 11TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWARDEN
Mailing Address - State:IA
Mailing Address - Zip Code:51023-1903
Mailing Address - Country:US
Mailing Address - Phone:712-551-3100
Mailing Address - Fax:712-551-3195
Practice Address - Street 1:321 MILL ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:IA
Practice Address - Zip Code:51001-7712
Practice Address - Country:US
Practice Address - Phone:712-568-2411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWARDEN REGIONAL HEALTHCARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-05
Last Update Date:2020-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty