Healthcare Provider Details

I. General information

NPI: 1013969252
Provider Name (Legal Business Name): PAWNEE COUNTY MEMORIAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 01/06/2021
Certification Date: 01/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 I ST
PAWNEE CITY NE
68420-3001
US

IV. Provider business mailing address

600 I ST
PAWNEE CITY NE
68420-3001
US

V. Phone/Fax

Practice location:
  • Phone: 402-852-2231
  • Fax: 402-852-2098
Mailing address:
  • Phone: 402-852-2231
  • Fax: 402-852-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License Number590001
License Number StateNE

VIII. Authorized Official

Name: RUTH STEPHENS
Title or Position: ADMINISTRATOR
Credential:
Phone: 402-852-2231