Healthcare Provider Details

I. General information

NPI: 1881985646
Provider Name (Legal Business Name): MED-CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/28/2011
Last Update Date: 04/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 56TH
KEARNEY NE
68847
US

IV. Provider business mailing address

603 N DIERS AVENUE SUITE 2
GRAND ISLAND NE
68803
US

V. Phone/Fax

Practice location:
  • Phone: 308-237-9696
  • Fax: 308-237-4517
Mailing address:
  • Phone: 308-398-1147
  • Fax: 308-398-1149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number21104
License Number StateNE

VIII. Authorized Official

Name: DR. J PAUL MEYER
Title or Position: PHYSICIAN
Credential: M.D.
Phone: 308-398-1147