Healthcare Provider Details

I. General information

NPI: 1801917380
Provider Name (Legal Business Name): LITZENBERG MEM CNTY HOSP PHCY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 08/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST RR2 BOX 1
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

1715 26TH ST RR2 BOX 1
CENTRAL CITY NE
68826-9501
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-5981
  • Fax: 308-946-5911
Mailing address:
  • Phone: 308-946-5981
  • Fax: 308-946-5911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number2551
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: REGINALD HAIN
Title or Position: DIRECTOR OF PHARMACY
Credential: RP
Phone: 308-946-5981