Healthcare Provider Details
I. General information
NPI: 1942381017
Provider Name (Legal Business Name): PLAINVIEW PUBLIC HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/17/2006
Last Update Date: 02/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
101 W HARPER AVE
PLAINVIEW NE
68769-2037
US
IV. Provider business mailing address
PO BOX 489
PLAINVIEW NE
68769-0489
US
V. Phone/Fax
- Phone: 402-582-4249
- Fax: 402-582-4229
- Phone: 402-582-4245
- Fax: 402-582-3940
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | 621001 |
| License Number State | NE |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
| # 1 | |
| Identifier | 00622 |
| Identifier Type | OTHER |
| Identifier State | NE |
| Identifier Issuer | HOME HEALTH (BCBS OF NE) |
| # 2 | |
| Identifier | 08922 |
| Identifier Type | OTHER |
| Identifier State | NE |
| Identifier Issuer | HHA SUPPLIES (BCBS OF NE) |
VIII. Authorized Official
Name: MR.
RICHARD
B.
GAMEL
Title or Position: CEO/ADMINISTRATOR
Credential:
Phone: 402-582-4245