Healthcare Provider Details

I. General information

NPI: 1194767285
Provider Name (Legal Business Name): COMMUNITY MEDICAL CENTER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2006
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3307 BILL SCHOCK BLVD
FALLS CITY NE
68355-2428
US

IV. Provider business mailing address

PO BOX 399
FALLS CITY NE
68355-0399
US

V. Phone/Fax

Practice location:
  • Phone: 402-245-4475
  • Fax: 402-245-6651
Mailing address:
  • Phone: 402-245-4475
  • Fax: 402-245-6651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RYAN CHADWICK LARSEN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 402-245-6500