Healthcare Provider Details

I. General information

NPI: 1700979622
Provider Name (Legal Business Name): OSMOND GENERAL HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 11/23/2020
Certification Date: 11/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N LINCOLN ST
WAUSA NE
68786-2050
US

IV. Provider business mailing address

PO BOX 429
OSMOND NE
68765-0429
US

V. Phone/Fax

Practice location:
  • Phone: 402-586-2244
  • Fax: 402-586-2580
Mailing address:
  • Phone: 402-748-3393
  • Fax: 402-748-6190

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. LON M. KNIEVEL
Title or Position: CEO
Credential:
Phone: 402-748-3393