Healthcare Provider Details

I. General information

NPI: 1255379061
Provider Name (Legal Business Name): NORTH PLATTE NEBRASKA HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 10/18/2024
Certification Date: 10/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

601 W LEOTA ST
NORTH PLATTE NE
69101-6598
US

IV. Provider business mailing address

601 W LEOTA ST
NORTH PLATTE NE
69101-6598
US

V. Phone/Fax

Practice location:
  • Phone: 308-568-7496
  • Fax: 308-568-7396
Mailing address:
  • Phone: 308-568-7496
  • Fax: 308-568-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number510001
License Number StateNE

VIII. Authorized Official

Name: SUMMER D OWEN
Title or Position: CFO
Credential:
Phone: 308-568-7496