| Organization Name: | BUENA VISTA REGIONAL MEDICAL CENTER |
| NPI Number: | 1164593109 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTA L KETCHAM (CFO) |
| Mailing Address: | 1525 W 5th St Storm Lake |
| State: | IA US |
| Postal Code: | 505883027 |
| Phone Number: | 7127324030 |
| Fax Number: | 7122131233 |
| NPI Enumeration Date: | 11/13/2006 |
| NPI Last Update Date: | 07/08/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207PE0004X |
| License Number: | 166H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Emergency Medicine |
| Taxonomy Specialization: | Emergency Medical Services |
| Taxonomy Definition: | An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |