Healthcare Provider Details

I. General information

NPI: 1801976345
Provider Name (Legal Business Name): PANHANDLE HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 W 42ND ST SUITE 1200
SCOTTSBLUFF NE
69361-4669
US

IV. Provider business mailing address

2 W 42ND ST SUITE 1200
SCOTTSBLUFF NE
69361-4669
US

V. Phone/Fax

Practice location:
  • Phone: 308-630-1811
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: CURT COPPLE
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 308-630-1811