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NPI Code Detail

MEDICARE: PROVIDENCE MEDICAL CENTER

MEDICARE: PROVIDENCE MEDICAL CENTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1275N00000XMedicare Defined Swing Bed Hospital Unit800001NE

General Provider Information

NPI Number : 1255470092
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE MEDICAL CENTER
Provider Business Mailing Address
First Line : 1200 PROVIDENCE RD.
Second Line :
City : WAYNE
State : NE
Zip : 68787-1212
Country : US
Telephone Number : 402-375-3800
Fax Number : 402-375-7989
Provider Business Practice Location Address
First Line : 1200 PROVIDENCE RD
Second Line :
City : WAYNE
State : NE
Zip : 68787-1212
Country : US
Telephone Number : 402-375-3800
Fax Number : 402-375-7989
Authorized Official
Title or Position : CEO
Name : NICOLE R HAGLUND
Credential :
Telephone Number : 402-375-3800
Provider Enumeration Date : 02/06/2007
Last Update Date : 03/11/2025

Similar Medicare Providers

1801867494 — PROVIDENCE MEDICAL CENTER
Practice Location Address:
1200 PROVIDENCE ROAD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7960
Practice Fax: 402-375-7989
1477811065 — ANDREA JOHNSON PT, DPT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax: 402-375-7956
1093073694 — JEAN ANN HARROLD-LOBERG P.T.
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax:
1558629154 — MOLLY MARIE REDDEN PT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax:
1114285798 — MISS DAWN MONIQUE ADDISON-CORBIT PT,DPT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax: 402-375-7956
1598134751 — MORGAN EBBERSON
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-3800
Practice Fax:

Directions to “PROVIDENCE MEDICAL CENTER ” Practice Location

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