Healthcare Provider Details
I. General information
NPI: 1811079775
Provider Name (Legal Business Name): DUNDY COUNTY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/19/2006
Last Update Date: 12/27/2024
Certification Date: 12/27/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1313 N CHEYENNE ST
BENKELMAN NE
69021-3074
US
IV. Provider business mailing address
PO BOX 626
BENKELMAN NE
69021-0626
US
V. Phone/Fax
- Phone: 308-423-2204
- Fax: 308-423-5691
- Phone: 308-423-2204
- Fax: 308-423-5691
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 275N00000X |
| Taxonomy | Medicare Defined Swing Bed Hospital Unit |
| License Number | 270001 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 270001 |
| License Number State | NE |
VIII. Authorized Official
Name:
JEREMIAH
W
HANES
Title or Position: CEO
Credential:
Phone: 308-423-2204