Healthcare Provider Details

I. General information

NPI: 1548269368
Provider Name (Legal Business Name): COLUMBUS MEDICAL CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1454 28TH AVE
COLUMBUS NE
68601-4944
US

IV. Provider business mailing address

1454 28TH AVE
COLUMBUS NE
68601-4944
US

V. Phone/Fax

Practice location:
  • Phone: 402-564-2816
  • Fax: 402-564-1312
Mailing address:
  • Phone: 402-564-2816
  • Fax: 402-564-1312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EDWARD DISCOE
Title or Position: OWNER
Credential: M.D.
Phone: 402-564-2816