Healthcare Provider Details

I. General information

NPI: 1780811323
Provider Name (Legal Business Name): HOWARD COUNTY MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2009
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 SHERMAN ST
SAINT PAUL NE
68873
US

IV. Provider business mailing address

1113 SHERMAN ST PO BOX 406
SAINT PAUL NE
68873-0406
US

V. Phone/Fax

Practice location:
  • Phone: 308-754-4421
  • Fax: 308-754-4429
Mailing address:
  • Phone: 308-754-4421
  • Fax: 308-754-4429

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number430001
License Number StateNE

VIII. Authorized Official

Name: MORGAN MEYER
Title or Position: CFO
Credential:
Phone: 308-754-4421