1174047971 NPI number — EAST CENTRAL DISTRICT HEALTH DEPARTMENT

Table of content: (NPI 1174047971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174047971 NPI number — EAST CENTRAL DISTRICT HEALTH DEPARTMENT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EAST CENTRAL DISTRICT HEALTH DEPARTMENT
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:
Provider Other Organization Name Type Code:
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:
1174047971
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/02/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1028
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLUMBUS
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68602-1028
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-562-8952
Provider Business Mailing Address Fax Number:
402-564-0611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
632 W FAIRVIEW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBION
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68620
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-563-9224
Provider Business Practice Location Address Fax Number:
402-564-0611
Provider Enumeration Date:
08/02/2017

Additional Information

Authorized Official

Authorized Official Last Name:
RODGERS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
INTERMIN CEO
Authorized Official Telephone Number:
402-562-7500

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com