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General NPI Number Information
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NPI Number | 1952414526
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Entity Type | Organization
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Legal Business Name | PANHANDLE HEALTH SERVICES
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 2 W 42ND ST SUITE 2550
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-4669
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Country | US
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Telephone | 308-630-1947
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Fax | 308-630-1439
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Provider Business Mailing Address
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Address Line | 2 W 42ND ST SUITE 2550
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City | SCOTTSBLUFF
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State | NE
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Zip | 69361-4669
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Country | US
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Telephone | 308-630-1947
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Fax | 308-630-1439
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SARA J KISHIYAMA
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Credential |
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Telephone | 308-630-1947
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | NE
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