Healthcare Provider Details

I. General information

NPI: 1699845016
Provider Name (Legal Business Name): MEMORIAL HEALTH CARE SYSTEMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/21/2021
Certification Date: 01/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N COLUMBIA AVE
SEWARD NE
68434-2299
US

IV. Provider business mailing address

250 N COLUMBIA AVE
SEWARD NE
68434-2248
US

V. Phone/Fax

Practice location:
  • Phone: 402-643-2971
  • Fax: 402-646-4605
Mailing address:
  • Phone: 402-643-4800
  • Fax: 402-646-4635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY E. JERGER
Title or Position: CFO
Credential:
Phone: 402-643-2971