Healthcare Provider Details

I. General information

NPI: 1295920981
Provider Name (Legal Business Name): GREATER SANDHILLS FAMILY HEALTHCARE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 01/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E SOUTH STREET
BASSETT NE
68714-0146
US

IV. Provider business mailing address

PO BOX 146
BASSETT NE
68714-0146
US

V. Phone/Fax

Practice location:
  • Phone: 402-684-2285
  • Fax: 402-684-2299
Mailing address:
  • Phone: 402-684-2285
  • Fax: 402-684-2299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN D TUBBS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 402-924-3660