Healthcare Provider Details

I. General information

NPI: 1396969499
Provider Name (Legal Business Name): ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 01/20/2022
Certification Date: 01/20/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 S 25TH AVE
OMAHA NE
68131-3654
US

IV. Provider business mailing address

PO BOX 776199
CHICAGO IL
60677-6199
US

V. Phone/Fax

Practice location:
  • Phone: 402-717-5300
  • Fax: 402-717-1097
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License NumberH000110
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: EVERT KUIPER
Title or Position: CEO - CHI HEALTH
Credential:
Phone: 402-343-4420