MEDICARE: MEMORIAL COMMUNITY HOSPITAL CORPORATION

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
1	261QC0050X	Critical Access Hospital Clinic/Center
2	282NC0060X	Critical Access Hospital	790001	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00088	OTHER	NE	BLUE CROSS

General Provider Information

NPI Number	:	1265408819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MEMORIAL COMMUNITY HOSPITAL CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 250
Second Line	:
City	:	BLAIR
State	:	NE
Zip	:	68008-1128
Country	:	US
Telephone Number	:	402-426-2182
Fax Number	:	402-426-1191

Provider Business Practice Location Address
First Line	:	810 N 22ND ST
Second Line	:
City	:	BLAIR
State	:	NE
Zip	:	68008-1128
Country	:	US
Telephone Number	:	402-426-2182
Fax Number	:	406-426-1181

Authorized Official
Title or Position	:	CNE/VP PATIENT CARE SERVICES
Name	:	AMY ZIMMER
Credential	:
Telephone Number	:	402-426-2182

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	04/18/2025

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Directions to “MEMORIAL COMMUNITY HOSPITAL CORPORATION ” Practice Location

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