Healthcare Provider Details

I. General information

NPI: 1982774964
Provider Name (Legal Business Name): MEMORIAL HEALTH CARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 12/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N COLUMBIA AVE
SEWARD NE
68434-2299
US

IV. Provider business mailing address

300 N COLUMBIA AVE
SEWARD NE
68434-2299
US

V. Phone/Fax

Practice location:
  • Phone: 402-643-2971
  • Fax: 402-646-4605
Mailing address:
  • Phone: 402-646-4628
  • Fax: 402-646-4605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY E. JERGER
Title or Position: CFO
Credential:
Phone: 402-646-4628