Provider Demographics
NPI:1669802955
Name:WASHINGTON COUNTY HOSPITAL
Entity type:Organization
Organization Name:WASHINGTON COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-863-3901
Mailing Address - Street 1:PO BOX 909
Mailing Address - Street 2:1230 S. IOWA AVENUE
Mailing Address - City:WASHINGTON
Mailing Address - State:IA
Mailing Address - Zip Code:52353-0909
Mailing Address - Country:US
Mailing Address - Phone:319-653-7291
Mailing Address - Fax:
Practice Address - Street 1:1230 S IOWA AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:IA
Practice Address - Zip Code:52353-1144
Practice Address - Country:US
Practice Address - Phone:319-653-7291
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-22
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA16D0386746OtherCLIA
IA16-8567OtherMEDICARE PTAN