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NPI Code Detail

MEDICARE: THREE CEDARS INC.

MEDICARE: THREE CEDARS INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1253Z00000XIn Home Supportive Care Agency
2251E00000XHome Health Agency

General Provider Information

NPI Number : 1548814569
Entity Type Code : Organization
Provider Name (Legal Business Name) : THREE CEDARS INC.
Provider Business Mailing Address
First Line : 1007 N JEFFERS ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-3028
Country : US
Telephone Number : 308-532-3960
Fax Number : 308-532-4676
Provider Business Practice Location Address
First Line : 1007 N JEFFERS ST
Second Line :
City : NORTH PLATTE
State : NE
Zip : 69101-3028
Country : US
Telephone Number : 308-532-3960
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MR. STEVE RALPH CHATELAIN
Credential :
Telephone Number : 308-532-3960
Provider Enumeration Date : 07/29/2019
Last Update Date : 07/29/2019

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