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General NPI Number Information
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NPI Number | 1265502538
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Entity Type | Organization
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Legal Business Name | GOTHENBURG MEMORIAL HOSPITAL
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 910 20TH ST
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City | GOTHENBURG
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State | NE
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Zip | 69138-1253
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Country | US
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Telephone | 308-537-3661
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Fax | 307-537-3074
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Provider Business Mailing Address
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Address Line | PO BOX 469
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City | GOTHENBURG
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State | NE
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Zip | 69138-0469
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Country | US
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Telephone | 308-537-3661
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Fax | 308-537-3074
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Authorized Official
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Title or Position | CEO
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Name | ANDREW D KNUST
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Credential |
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Telephone | 308-537-3661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 220002
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License Number State | NE
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