Healthcare Provider Details

I. General information

NPI: 1174509194
Provider Name (Legal Business Name): THAYER COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 PARK AVE
HEBRON NE
68370
US

IV. Provider business mailing address

120 PARK AVE
HEBRON NE
68370-2019
US

V. Phone/Fax

Practice location:
  • Phone: 402-768-4625
  • Fax: 402-768-4669
Mailing address:
  • Phone: 402-768-4625
  • Fax: 402-768-4669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number760001
License Number StateNE

VIII. Authorized Official

Name: DAVID BURD
Title or Position: CEO
Credential:
Phone: 402-768-4614