1871608174 NPI number — BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871608174 NPI number — BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC

Employer Identification Number (EIN):

Provider Organization Name:

BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC

Provider Last Name:

Provider First Name:

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

Provider Gender Code:

Provider Other Organization Name:

WYMORE MEDICAL CLINIC

Provider Other Organization Name Type Code:

5

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:

1871608174

Entity Type Code:

Organization

Replacement NPI:

Last Update Date:

09/30/2022

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 278

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BEATRICE

Provider Business Mailing Address State Name:

NE

Provider Business Mailing Address Postal Code:

68310-0278

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

402-228-3344

Provider Business Mailing Address Fax Number:

402-223-7299

Provider First Line Business Practice Location Address:

116 E H ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

WYMORE

Provider Business Practice Location Address State Name:

NE

Provider Business Practice Location Address Postal Code:

68466-1702

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

402-645-3310

Provider Business Practice Location Address Fax Number:

402-645-3397

Provider Enumeration Date:

08/20/2006

Authorized Official Last Name:

JURGENS

Authorized Official First Name:

CHAD

Authorized Official Middle Name:

Authorized Official Title or Position:

CFO

Authorized Official Telephone Number:

402-223-7224

• Taxonomy code: 261QR1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2281 . This is a "MIDLANDS CHOICE #DH" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 37668 . This is a "BC # DH" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 30327 . This is a "BC #DW" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 37665 . This is a "BC # SL" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 7928 . This is a "MIDLANDS CHOICE #JC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 1935 . This is a "MIDLANDS CHOICE DW" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 230068 . This is a "MIDLANDS CHOICE #SL" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 30768 . This is a "BLUE CROSS CLINIC #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 47037984003 . This is a "TRICARE PROVIDER #" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
• Identifier: 32297 . This is a "BC # JC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".