Healthcare Provider Details
I. General information
NPI: 1285767236
Provider Name (Legal Business Name): MEMORIAL COMMUNITY HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/13/2007
Last Update Date: 10/04/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
812 N. 22ND STREET
BLAIR NE
68008-1128
US
IV. Provider business mailing address
P.O BOX 286
BLAIR NE
68008-1128
US
V. Phone/Fax
- Phone: 402-426-4611
- Fax: 402-426-4642
- Phone: 402-426-4611
- Fax: 402-426-1297
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
AMY
ZIMMER
Title or Position: CNE/VP PATIENT CARE SERVICES
Credential:
Phone: 402-426-2182