| NPI | 1508431875 |
|---|---|
| Former Legal Business Name | GREAT RIVER MEDICAL CENTER |
| Doing Business As | SOUTHEAST IOWA REGIONAL MEDICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | MICHAEL MCCOY CEO 319-768-3268 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-05-20 |
| Last Update Date | 2022-10-18 |