Healthcare Provider Details

I. General information

NPI: 1053515874
Provider Name (Legal Business Name): THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2007
Last Update Date: 04/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N KANSAS AVE STE 204
HASTINGS NE
68901-4438
US

IV. Provider business mailing address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4497
US

V. Phone/Fax

Practice location:
  • Phone: 402-461-5358
  • Fax: 402-461-5368
Mailing address:
  • Phone: 402-463-4521
  • Fax: 402-461-5321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number StateNE

VIII. Authorized Official

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