Healthcare Provider Details

I. General information

NPI: 1922173061
Provider Name (Legal Business Name): WEST HOLT MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

406 W NEELY ST
ATKINSON NE
68713-4801
US

IV. Provider business mailing address

406 W NEELY ST
ATKINSON NE
68713-4801
US

V. Phone/Fax

Practice location:
  • Phone: 402-925-2811
  • Fax: 402-925-2810
Mailing address:
  • Phone: 402-925-2811
  • Fax: 402-925-2810

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number4100001
License Number StateNE

VIII. Authorized Official

Name: JEREMY BAUER
Title or Position: CFO
Credential:
Phone: 402-925-1947