1427147883 NPI number — NEBRASKA METHODIST HOSPITAL

Table of content: (NPI 1427147883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427147883 NPI number — NEBRASKA METHODIST HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEBRASKA METHODIST 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:
METHODIST 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:
1427147883
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2797
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68103-2797
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-354-4230
Provider Business Mailing Address Fax Number:
402-354-6171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8303 DODGE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-354-4000
Provider Business Practice Location Address Fax Number:
402-354-8735
Provider Enumeration Date:
10/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GOESER
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT & COO
Authorized Official Telephone Number:
402-354-4449

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  260008 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 282NW0100X , with the licence number: H000116 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0901108 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025105100 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00004 . This is a "BCBS OF NE" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 5000043 . This is a "UHC" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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