Healthcare Provider Details

I. General information

NPI: 1093754996
Provider Name (Legal Business Name): COUNTY OF RED WILLOW
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 11/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 W 5TH ST
MC COOK NE
69001-2552
US

IV. Provider business mailing address

1400 W 5TH ST
MC COOK NE
69001-2552
US

V. Phone/Fax

Practice location:
  • Phone: 308-345-1790
  • Fax: 308-345-1794
Mailing address:
  • Phone: 308-345-1790
  • Fax: 308-345-1794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. DARCEY HANSEN
Title or Position: COUNTY HEALTH DIRECTOR
Credential: R.N.
Phone: 308-345-1790