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General NPI Number Information
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NPI Number | 1942228820
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Entity Type | Organization
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Legal Business Name | PHYSICIAN HOMECARE ASSOCIATES
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 06/08/2009
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Provider Practice Location Address
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Address Line | 51 GINGER WOODS RD
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City | VALLEY
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State | NE
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Zip | 68064-9404
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Country | US
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Telephone | 402-639-6660
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Fax | 402-359-2852
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Provider Business Mailing Address
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Address Line | 51 GINGER WOODS RD
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City | VALLEY
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State | NE
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Zip | 68064-9404
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Country | US
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Telephone | 402-639-6660
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Fax | 402-359-2852
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | BERNARD C HILLYER
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Credential | MD
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Telephone | 402-639-6660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 21349
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License Number State | NE
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