Healthcare Provider Details

I. General information

NPI: 1649202839
Provider Name (Legal Business Name): GOOD SAMARITAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 E 31ST ST
KEARNEY NE
68847-2926
US

IV. Provider business mailing address

10 E 31ST ST
KEARNEY NE
68847-2926
US

V. Phone/Fax

Practice location:
  • Phone: 308-865-7100
  • Fax: 308-865-7913
Mailing address:
  • Phone: 308-865-7900
  • Fax: 308-865-2913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. EVERT KUIPER
Title or Position: CEO
Credential:
Phone: 402-343-4420