Healthcare Provider Details

I. General information

NPI: 1285686642
Provider Name (Legal Business Name): SANDHILLS DISTRICT HEALTH DEPARTMENT & CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 11/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 RIVER RD POB 784
OGALLALA NE
69153-3009
US

IV. Provider business mailing address

55 RIVER RD POB 784
OGALLALA NE
69153-3009
US

V. Phone/Fax

Practice location:
  • Phone: 308-284-6054
  • Fax: 308-284-4833
Mailing address:
  • Phone: 308-284-6054
  • Fax: 308-284-4833

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: RHONDA J THEILER
Title or Position: DIRECTOR
Credential: RN, BSN
Phone: 308-284-6054