Healthcare Provider Details

I. General information

NPI: 1275622250
Provider Name (Legal Business Name): PLAINVIEW PUBLIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 N 3RD ST
PLAINVIEW NE
68769-2047
US

IV. Provider business mailing address

PO BOX 489
PLAINVIEW NE
68769-0489
US

V. Phone/Fax

Practice location:
  • Phone: 402-582-4245
  • Fax: 402-582-3940
Mailing address:
  • Phone: 402-582-4245
  • Fax: 402-582-3940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier08580
Identifier TypeOTHER
Identifier StateNE
Identifier IssuerPROF SVCS-CRNA (BCBS-NE)
# 2
Identifier01555
Identifier TypeOTHER
Identifier StateNE
Identifier IssuerPROF SVCS-ER (BCBS OF NE)

VIII. Authorized Official

Name: MR. RICHARD B. GAMEL
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 402-582-4245