Healthcare Provider Details

I. General information

NPI: 1396753323
Provider Name (Legal Business Name): MEMORIAL COMMUNITY HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 01/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 7TH ST
AURORA NE
68818-1141
US

IV. Provider business mailing address

1423 7TH ST
AURORA NE
68818-1141
US

V. Phone/Fax

Practice location:
  • Phone: 402-694-3171
  • Fax: 402-694-5350
Mailing address:
  • Phone: 402-694-3171
  • Fax: 402-694-5350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number380001
License Number StateNE

VIII. Authorized Official

Name: MR. PHIL FENDT
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 402-694-8204