Healthcare Provider Details

I. General information

NPI: 1902961105
Provider Name (Legal Business Name): CHEYENNE COUNTY HOSPITAL ASSOCIATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 N SPRUCE ST
OGALLALA NE
69153-2549
US

IV. Provider business mailing address

645 OSAGE ST
SIDNEY NE
69162-1714
US

V. Phone/Fax

Practice location:
  • Phone: 308-284-4078
  • Fax:
Mailing address:
  • Phone: 308-254-3273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number251E00000X
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number251G00000X
License Number StateNE

VIII. Authorized Official

Name: DANIELLE JOHNSON
Title or Position: CEO
Credential:
Phone: 308-254-5070