Healthcare Provider Details

I. General information

NPI: 1730113150
Provider Name (Legal Business Name): BOONE COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 BROADWAY ST
FULLERTON NE
68638-3155
US

IV. Provider business mailing address

PO BOX 151
ALBION NE
68620-0151
US

V. Phone/Fax

Practice location:
  • Phone: 308-536-2446
  • Fax: 308-536-2727
Mailing address:
  • Phone: 402-395-3213
  • Fax: 402-395-3173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CALEB K POORE
Title or Position: CEO
Credential:
Phone: 402-395-3213