1952355307 NPI number — TILDEN COMMUNITY HOSPITAL & RURAL HEALTH CLINIC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952355307 NPI number — TILDEN COMMUNITY HOSPITAL & RURAL HEALTH CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TILDEN COMMUNITY HOSPITAL & RURAL HEALTH CLINIC
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:
1952355307
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 340
Provider Second Line Business Mailing Address:
308 WEST 2ND
Provider Business Mailing Address City Name:
TILDEN
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68781-0340
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-368-5343
Provider Business Mailing Address Fax Number:
402-368-7746

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308 W 2ND ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TILDEN
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68781-4760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-368-5343
Provider Business Practice Location Address Fax Number:
402-368-7746
Provider Enumeration Date:
05/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MITCHELL
Authorized Official First Name:
SARAH
Authorized Official Middle Name:
M
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
402-368-5343

Provider Taxonomy Codes

  • Taxonomy code: 282NC0060X , with the licence number:  020002 , 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: 60092 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 10025296800 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com