1538262811 NPI number — GARDEN COUNTY HOSPITAL & NURSING HOME

Table of content: (NPI 1538262811)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538262811 NPI number — GARDEN COUNTY HOSPITAL & NURSING HOME

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GARDEN COUNTY HOSPITAL & NURSING HOME
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:
THE RIVERVIEW ASSISTED LIVING
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:
1538262811
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEWELLEN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
69147-0320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-778-5351
Provider Business Mailing Address Fax Number:
308-778-5300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 EAST CHURCH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWELLEN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
69147-0320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-778-5351
Provider Business Practice Location Address Fax Number:
308-778-5300
Provider Enumeration Date:
09/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HANSEL
Authorized Official First Name:
JIM
Authorized Official Middle Name:
W
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
308-772-3283

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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