Healthcare Provider Details

I. General information

NPI: 1104963164
Provider Name (Legal Business Name): THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US

IV. Provider business mailing address

715 N SAINT JOSEPH AVE
HASTINGS NE
68901-4451
US

V. Phone/Fax

Practice location:
  • Phone: 402-463-4521
  • Fax: 402-461-5040
Mailing address:
  • Phone: 402-463-4521
  • Fax: 402-461-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNE

VIII. Authorized Official

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