1003949553 NPI number — WEBSTER COUNTY COMMUNITY HOSPITAL

Table of content: (NPI 1003949553)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003949553 NPI number — WEBSTER COUNTY COMMUNITY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WEBSTER COUNTY COMMUNITY HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WEBSTER COUNTY CLINIC
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003949553
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
09/05/2013
NPI Reactivation Date:
07/20/2016

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
721 W 6TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RED CLOUD
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68970-2278
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-746-5614
Provider Business Mailing Address Fax Number:
402-746-5684

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
420 UNIVERSITY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GUIDE ROCK
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68942-9998
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-257-2061
Provider Business Practice Location Address Fax Number:
402-257-2062
Provider Enumeration Date:
03/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HALLOCK
Authorized Official First Name:
MIRYA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
402-746-5600

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com