Healthcare Provider Details

I. General information

NPI: 1245343607
Provider Name (Legal Business Name): THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N KANSAS AVE STE 209
HASTINGS NE
68901-4483
US

IV. Provider business mailing address

715 N KANSAS AVE STE 205
HASTINGS NE
68901-4438
US

V. Phone/Fax

Practice location:
  • Phone: 402-460-5836
  • Fax:
Mailing address:
  • Phone: 402-461-5261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. ERIC A BARBER
Title or Position: CEO
Credential:
Phone: 402-461-5108