| Organization Name: | MONTGOMERY COUNTY MEMORIAL HOSPITAL |
| NPI Number: | 1790758092 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RONNEL K BADERTSCHER (BUSINESS OFFICE MANAGER) |
| Mailing Address: | 301 E 4th St Villisca |
| State: | IA US |
| Postal Code: | 508641146 |
| Phone Number: | 7128264422 |
| Fax Number: | 7128262052 |
| NPI Enumeration Date: | 02/08/2006 |
| NPI Last Update Date: | 04/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 690075H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |