Healthcare Provider Details
I. General information
NPI: 1881643484
Provider Name (Legal Business Name): COMMUNITY MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2006
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
- Phone: 402-245-2428
- Fax:
- Phone: 402-245-2428
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 3416L0300X |
| Taxonomy | Land Ambulance |
| License Number | 5102 |
| License Number State | NE |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 282NC0060X |
| Taxonomy | Critical Access Hospital |
| License Number | 660001 |
| License Number State | NE |
VIII. Authorized Official
Name: MR.
RYAN
C
LARSEN
Title or Position: CEO
Credential:
Phone: 402-245-2428