Healthcare Provider Details

I. General information

NPI: 1811913767
Provider Name (Legal Business Name): WEST HOLT MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 12/17/2021
Certification Date: 12/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 W PEARL ST
ATKINSON NE
68713-4958
US

IV. Provider business mailing address

PO BOX 277
ATKINSON NE
68713-0277
US

V. Phone/Fax

Practice location:
  • Phone: 402-925-2651
  • Fax: 402-925-2652
Mailing address:
  • Phone: 402-925-2651
  • Fax: 402-925-2652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number687
License Number StateNE

VIII. Authorized Official

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