Healthcare Provider Details

I. General information

NPI: 1134771256
Provider Name (Legal Business Name): CALLAWAY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 07/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 E KIMBALL ST
CALLAWAY NE
68825-2596
US

IV. Provider business mailing address

PO BOX 100
CALLAWAY NE
68825-0100
US

V. Phone/Fax

Practice location:
  • Phone: 308-836-2294
  • Fax: 308-836-2451
Mailing address:
  • Phone: 308-836-2228
  • Fax: 308-836-2733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BRETT D EGGLESTON
Title or Position: CEO
Credential:
Phone: 308-836-2228