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General NPI Number Information
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NPI Number | 1225658495
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Entity Type | Organization
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Legal Business Name | GRAND ISLAND REGIONAL MEDICAL CENTER
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Dates
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Enumeration Date | 04/17/2020
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 3533 PRAIRIEVIEW ST
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City | GRAND ISLAND
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State | NE
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Zip | 68803-4409
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Country | US
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Telephone | 308-675-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5225
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City | GRAND ISLAND
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State | NE
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Zip | 68802-5225
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Country | US
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Telephone | 308-675-5000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ANDREW P WATERMAN
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Credential |
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Telephone | 308-675-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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