Healthcare Provider Details

I. General information

NPI: 1275544017
Provider Name (Legal Business Name): ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2006
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 BEEBE ST
OSCEOLA NE
68651-5537
US

IV. Provider business mailing address

PO BOX 546
OSCEOLA NE
68651-0546
US

V. Phone/Fax

Practice location:
  • Phone: 402-747-8851
  • Fax: 402-747-1407
Mailing address:
  • Phone: 402-747-8851
  • Fax: 402-747-1407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH W. LOHRMAN
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 402-747-2031