1992885891 NPI number — LITZENBERG MEMORIAL MERRICK COUNTY

Table of content: (NPI 1992885891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992885891 NPI number — LITZENBERG MEMORIAL MERRICK COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LITZENBERG MEMORIAL MERRICK COUNTY
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:
LITZENBERG MEMORIAL COUNTY HOSPITAL
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:
1992885891
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/28/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1715 26TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CENTRAL CITY
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68826-9501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
308-946-3015
Provider Business Mailing Address Fax Number:
308-946-5914

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1715 26TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRAL CITY
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68826-9501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
308-946-3015
Provider Business Practice Location Address Fax Number:
308-946-5914
Provider Enumeration Date:
10/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURRAY
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
308-946-3015

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  530001 , 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: 00117 . This is a "BLUE CROSS HOSPITAL" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: D0659 . This is a "BLUE CROSS PHYSICIAN PROF" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: D08690 . This is a "CRNA PROF FEE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025163600 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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