Healthcare Provider Details

I. General information

NPI: 1801838800
Provider Name (Legal Business Name): COZAD COMMUNITY HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 07/08/2022
Certification Date: 07/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 MERIDIAN AVE
COZAD NE
69130-1754
US

IV. Provider business mailing address

PO BOX 207
COZAD NE
69130-0207
US

V. Phone/Fax

Practice location:
  • Phone: 308-784-4630
  • Fax: 308-784-4635
Mailing address:
  • Phone: 308-784-4630
  • Fax: 308-784-4635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberHOSPICE 6
License Number StateNE

VIII. Authorized Official

Name: ROBERT J DYER
Title or Position: CEO
Credential:
Phone: 308-784-2261