Healthcare Provider Details

I. General information

NPI: 1720095755
Provider Name (Legal Business Name): PERKINS COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 CENTRAL AVE
GRANT NE
69140-3099
US

IV. Provider business mailing address

900 LINCOLN AVE
GRANT NE
69140-3095
US

V. Phone/Fax

Practice location:
  • Phone: 308-352-7100
  • Fax: 308-352-7103
Mailing address:
  • Phone: 308-352-7100
  • Fax: 308-352-7103

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number4142
License Number StateNE

VIII. Authorized Official

Name: JAMES LEBRUN
Title or Position: CEO
Credential:
Phone: 308-352-7200