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General NPI Number Information
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NPI Number | 1790194918
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Entity Type | Organization
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Legal Business Name | KEARNEY REGIONAL MEDICAL CENTER LLC
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Dates
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Enumeration Date | 08/13/2014
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Last Update Date | 09/03/2014
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Provider Practice Location Address
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Address Line | 816 22ND AVE SUITE 100
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City | KEARNEY
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State | NE
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Zip | 68845-2206
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Country | US
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Telephone | 308-865-2263
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Fax | 308-865-2541
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Provider Business Mailing Address
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Address Line | 816 22ND AVE SUITE 100
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City | KEARNEY
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State | NE
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Zip | 68845-2206
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Country | US
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Telephone | 308-865-2263
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Fax | 308-865-2541
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | TOM MCLEOD
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Credential |
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Telephone | 308-865-2263
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | NE
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