Healthcare Provider Details

I. General information

NPI: 1083790893
Provider Name (Legal Business Name): ANTELOPE MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 11/18/2022
Certification Date: 11/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 W 9TH ST
NELIGH NE
68756-1114
US

IV. Provider business mailing address

PO BOX 229
NELIGH NE
68756-0229
US

V. Phone/Fax

Practice location:
  • Phone: 402-887-4151
  • Fax: 402-887-4092
Mailing address:
  • Phone: 402-887-4151
  • Fax: 402-887-4092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number020001
License Number StateNE

VIII. Authorized Official

Name: DIANE M BRUGGER
Title or Position: ADMINISTRATOR
Credential:
Phone: 402-887-4151