=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770589764
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ROCK COUNTY HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/23/2005
-----------------------------------------------------
Last Update Date | 09/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 801 S STATE ST
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68714-5062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-684-2906
-----------------------------------------------------
Fax | 402-684-3822
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 801 S STATE ST
-----------------------------------------------------
City | BASSETT
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68714-5062
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-684-2906
-----------------------------------------------------
Fax | 402-684-3822
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE MANAGER
-----------------------------------------------------
Name | PAMELA S LICKING
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-684-2906
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QR1300X
-----------------------------------------------------
Taxonomy Name | Rural Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------