National Provider Identifier Database

MARENGO MEMORIAL HOSPITAL
Critical Access


Contact Information

MARENGO MEMORIAL HOSPITAL
300 W MAY ST
MARENGO, IA52301-1261
Phone: 319-642-5543
Fax: 319-642-8007
Website:
Specialty Taxonomy Code
* Critical Access 282NC0060X
Critical Access Hospital 261QC0050X
Home Delivered Meals 332U00000X
Personal Emergency Response Attendant 146D00000X

* Indicates primary specialty

NPI Profile & details for MARENGO MEMORIAL HOSPITAL

NPI Number 1053368191
Legal business name
LBN
MARENGO MEMORIAL HOSPITAL
Authorized official BARRY GOETTSCH - (CEO)
Entity Organization
Organization subpart No
Enumeration date 05/27/2006
Last updated 01/21/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • IA Medicaid: 0153890
  • IA Medicaid: 0164533
  • IA Medicaid: 0600734
  • IA Other: 60073 HOSPITAL BCBS NUMBER
  • IA Other: 15389 PHYSICIAN GROUP BCBS #
  • IA Other: 15389 PHYSICIAN GROUP MEDICARE#

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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