| Organization Name: | JACKSON COUNTY PUBLIC HOSPITAL |
| NPI Number: | 1316901606 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CURT M COLEMAN (CEO) |
| Mailing Address: | 700 W Grove St Maquoketa |
| State: | IA US |
| Postal Code: | 520602163 |
| Phone Number: | 5636522474 |
| Fax Number: | 5636524096 |
| NPI Enumeration Date: | 04/13/2006 |
| NPI Last Update Date: | 12/15/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QE0700X |
| License Number: | 490099H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | End-Stage Renal Disease (ESRD) Treatment |
| Taxonomy Definition: | |