Healthcare Provider Details

I. General information

NPI: 1619164167
Provider Name (Legal Business Name): ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2007
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1109 MAIN ST
HAMBURG IA
51640-1233
US

IV. Provider business mailing address

7070 SPRING ST
OMAHA NE
68106-3519
US

V. Phone/Fax

Practice location:
  • Phone: 712-382-2051
  • Fax: 402-898-8484
Mailing address:
  • Phone: 402-898-8403
  • Fax: 402-898-8484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BX2000X
TaxonomyOxygen Equipment & Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: EVERT KUIPER
Title or Position: CEO
Credential:
Phone: 402-343-4420