1821001405 NPI number — JOHNSON COUNTY HOSPITAL

Table of content: (NPI 1821001405)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821001405 NPI number — JOHNSON COUNTY HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNSON COUNTY 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:
JOHNSON COUNTY HOSPITAL HOME HEALTH SERVICES
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:
1821001405
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 599
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TECUMSEH
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68450-0599
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-335-3371
Provider Business Mailing Address Fax Number:
402-335-3447

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
202 HIGH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TECUMSEH
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68450-2443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-335-3361
Provider Business Practice Location Address Fax Number:
402-335-6342
Provider Enumeration Date:
08/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KENT
Authorized Official First Name:
MARY
Authorized Official Middle Name:
JANE
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
402-335-3361

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  451001 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00419 . This is a "BCBS OF NEBRASKA" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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