MEDICARE: FAMILY HEALTH CARE OF COLUMBUS P.C.

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
1	261Q00000X	Clinic/Center	18870	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	00334	OTHER	NE	BCBS NE

General Provider Information

NPI Number	:	1568520450
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY HEALTH CARE OF COLUMBUS P.C.

Provider Business Mailing Address
First Line	:	2485 39TH AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-2256
Country	:	US
Telephone Number	:	402-564-9575
Fax Number	:	402-562-7472

Provider Business Practice Location Address
First Line	:	2485 39TH AVE
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68601-2256
Country	:	US
Telephone Number	:	402-564-9575
Fax Number	:	402-562-7472

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARCIA GOERING
Credential	:	M.D.
Telephone Number	:	402-564-9575

Provider Enumeration Date	:	12/05/2006
Last Update Date	:	08/22/2020

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