Healthcare Provider Details

I. General information

NPI: 1639273808
Provider Name (Legal Business Name): JEFFERSON COMMUNITY HEALTH CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2006
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 H ST BOX 277
FAIRBURY NE
68352-1119
US

IV. Provider business mailing address

2200 H ST BOX 277
FAIRBURY NE
68352-1119
US

V. Phone/Fax

Practice location:
  • Phone: 402-729-3351
  • Fax: 402-729-2102
Mailing address:
  • Phone: 402-729-3351
  • Fax: 402-729-2102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number441001
License Number StateNE

VIII. Authorized Official

Name: CHAD E JURGENS
Title or Position: CEO
Credential:
Phone: 402-729-3351