Healthcare Provider Details

I. General information

NPI: 1043200462
Provider Name (Legal Business Name): BEATRICE MEDICAL CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 09/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 W COURT ST
BEATRICE NE
68310-3525
US

IV. Provider business mailing address

805 W COURT ST P. O. BOX 578
BEATRICE NE
68310-3525
US

V. Phone/Fax

Practice location:
  • Phone: 402-228-3366
  • Fax: 402-228-3502
Mailing address:
  • Phone: 402-228-3366
  • Fax: 402-228-3502

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number15796
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20597
License Number StateNE
# 4
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number12760
License Number StateNE

VIII. Authorized Official

Name: ALAN WAYNE LANGVARDT
Title or Position: PRESIDENT
Credential: MD FACP FACPE
Phone: 402-228-3366