=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992759781
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PAWNEE COUNTY MEMORIAL HOSPITAL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/19/2006
-----------------------------------------------------
Last Update Date | 07/24/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 I ST
-----------------------------------------------------
City | PAWNEE CITY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68420-3001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-852-2231
-----------------------------------------------------
Fax | 402-852-2098
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 I ST
-----------------------------------------------------
City | PAWNEE CITY
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68420-3001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-852-2231
-----------------------------------------------------
Fax | 402-852-2098
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | JOHN WERNER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 402-852-2231
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282NC0060X
-----------------------------------------------------
Taxonomy Name | Critical Access Hospital
-----------------------------------------------------
License Number | 590001
-----------------------------------------------------
License Number State | NE
-----------------------------------------------------