Healthcare Provider Details

I. General information

NPI: 1487730727
Provider Name (Legal Business Name): LITZENBERG MEMORIAL MERRICK COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2006
Last Update Date: 01/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

IV. Provider business mailing address

1715 26TH ST
CENTRAL CITY NE
68826-9501
US

V. Phone/Fax

Practice location:
  • Phone: 308-946-3015
  • Fax: 308-946-5914
Mailing address:
  • Phone: 308-946-3015
  • Fax: 308-946-5914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number530001
License Number StateNE

VIII. Authorized Official

Name: JULIE MURRAY
Title or Position: CEO
Credential:
Phone: 308-946-3015