1497952725 NPI number — THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

Table of content: (NPI 1497952725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497952725 NPI number — THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
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:
PULMONARY & SLEEP CLINIC-GRAND ISLAND
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:
1497952725
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
715 N KANSAS AVE
Provider Second Line Business Mailing Address:
SUITE 208
Provider Business Mailing Address City Name:
HASTINGS
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68901-4453
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-460-5787
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
908 N HOWARD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GRAND ISLAND
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68803-3556
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-384-4085
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NEET
Authorized Official First Name:
BRADLEY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT/CEO
Authorized Official Telephone Number:
402-461-5108

Provider Taxonomy Codes

  • Taxonomy code: 207RC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10025483300 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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