Healthcare Provider Details

I. General information

NPI: 1114952363
Provider Name (Legal Business Name): BOONE COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

632 W FAIRVIEW ST ROOM 4
ALBION NE
68620-1724
US

IV. Provider business mailing address

PO BOX 151
ALBION NE
68620-0151
US

V. Phone/Fax

Practice location:
  • Phone: 402-395-2191
  • Fax: 402-395-5165
Mailing address:
  • Phone: 402-395-3213
  • Fax: 402-395-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number031001
License Number StateNE

VIII. Authorized Official

Name: CALEB K POORE
Title or Position: CEO
Credential:
Phone: 402-395-3213