Healthcare Provider Details

I. General information

NPI: 1710531967
Provider Name (Legal Business Name): MEMORIAL COMMUNITY HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2019
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 N 22ND ST
BLAIR NE
68008-1128
US

IV. Provider business mailing address

PO BOX 250
BLAIR NE
68008-0250
US

V. Phone/Fax

Practice location:
  • Phone: 402-426-4611
  • Fax: 402-426-4642
Mailing address:
  • Phone: 402-426-2182
  • Fax: 402-426-1297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: AMY ZIMMER
Title or Position: CNE/VP PATIENT CARE SERVICES
Credential:
Phone: 402-426-2182