Healthcare Provider Details

I. General information

NPI: 1144592544
Provider Name (Legal Business Name): COLUMBUS COMMUNITY HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2012
Last Update Date: 09/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4508 38TH ST SUITE 133
COLUMBUS NE
68601-1668
US

IV. Provider business mailing address

PO BOX 1800
COLUMBUS NE
68602-1800
US

V. Phone/Fax

Practice location:
  • Phone: 402-563-3644
  • Fax: 402-564-5805
Mailing address:
  • Phone: 402-564-7118
  • Fax: 402-562-3378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. CHAD E VAN CLEAVE
Title or Position: VICE PRESIDENT FINANCE
Credential:
Phone: 402-562-3357