Provider Demographics
NPI:1861597122
Name:CASS COUNTY MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:CASS COUNTY MEMORIAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:ABBEY
Authorized Official - Middle Name:
Authorized Official - Last Name:STANGL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:712-243-7804
Mailing Address - Street 1:1501 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ATLANTIC
Mailing Address - State:IA
Mailing Address - Zip Code:50022-1936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1501 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ATLANTIC
Practice Address - State:IA
Practice Address - Zip Code:50022-1936
Practice Address - Country:US
Practice Address - Phone:712-243-3250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 363L00000X
IA150145H282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0266478Medicaid
IA0072553Medicaid
IA0416875Medicaid
IA10397OtherWELLMARK BCBS OF IOWA
IA26647OtherWELLMARK BC/BS OF IOWA
IA0093518Medicaid
IA03836OtherWELLMARK BC/BS OF IOWA
IA04792OtherWELLMARK BC/BS OF IOWA
IA26647Medicare PIN
IA03836OtherWELLMARK BC/BS OF IOWA
IA0416875Medicaid
IA03836Medicare PIN