Healthcare Provider Details

I. General information

NPI: 1578571329
Provider Name (Legal Business Name): COMMUNITY MEMORIAL HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 08/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1579 MIDLAND ST
SYRACUSE NE
68446-9732
US

IV. Provider business mailing address

PO BOX N
SYRACUSE NE
68446-0518
US

V. Phone/Fax

Practice location:
  • Phone: 402-269-2011
  • Fax: 402-269-7621
Mailing address:
  • Phone: 402-269-2011
  • Fax: 402-269-7621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number581003
License Number StateNE

VIII. Authorized Official

Name: MR. MICHAEL D. HARVEY
Title or Position: CEO
Credential:
Phone: 402-269-2011