Organization · Type 2 NPI

Pella Regional Health Center

Rural Health Clinic/Center · Sully, IA

NPI number 1104860808 Active

Practice location

704 3rd St
Sully, IA 50251-1016

Call (641) 594-3150 Map

Fax (641) 594-3795

Mailing address

P.o. Box 327, 704 3rd Street,
Sully, IA 50251

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	630165H (IA)

Rural Health Clinic/Center: Definition to come...

Another provider at this address

Diane L. Dejong, PHYSICIAN ASSISTANTPhysician Assistant Sully, IA NPI 1124008354

NPI record

NPI: 1104860808
Entity type: Organization (Type 2)
Issued: Jun 15, 2006
Last updated: Dec 6, 2022
Status: Active
Subpart: Yes of Pella Regional Health Center

Other names

<unavail>
Sully Family Health Center · doing business as
Sully Family Health Center · doing business as

Authorized official

Robert D Kroese
CEO
(641) 628-6604

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104860808

Pella Regional Health Center's National Provider Identifier is 1104860808, issued on Jun 15, 2006. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Sully, IA. The record was last updated on Dec 6, 2022.