Healthcare Provider Details

I. General information

NPI: 1528159308
Provider Name (Legal Business Name): COZAD COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 PAPIO LN
COZAD NE
69130-1138
US

IV. Provider business mailing address

PO BOX 86
COZAD NE
69130-0086
US

V. Phone/Fax

Practice location:
  • Phone: 308-784-3535
  • Fax: 308-784-3534
Mailing address:
  • Phone: 308-784-3535
  • Fax: 308-784-3534

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 Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateNE
# 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: ROBERT J DYER
Title or Position: CEO
Credential:
Phone: 308-784-2261