Healthcare Provider Details

I. General information

NPI: 1699891465
Provider Name (Legal Business Name): FAITH REGIONAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/28/2021
Certification Date: 07/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W NORFOLK AVE
NORFOLK NE
68701-4438
US

IV. Provider business mailing address

PO BOX 869
NORFOLK NE
68702-0869
US

V. Phone/Fax

Practice location:
  • Phone: 402-844-8299
  • Fax: 402-644-7267
Mailing address:
  • Phone: 402-644-7249
  • Fax: 402-644-7432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2553
License Number StateNE

VIII. Authorized Official

Name: KELLY A DRISCOLL
Title or Position: PRESIDENT/CEO
Credential:
Phone: 402-371-4880