MEDICARE: THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

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	207RX0202X	Medical Oncology Physician
2	207RH0003X	Hematology & Oncology Physician

General Provider Information

NPI Number	:	1588812796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	815 N KANSAS AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-4470
Country	:	US
Telephone Number	:	402-460-5899
Fax Number	:

Provider Business Practice Location Address
First Line	:	815 N KANSAS AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-4470
Country	:	US
Telephone Number	:	402-460-5899
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. ERIC A BARBER
Credential	:
Telephone Number	:	402-461-5108

Provider Enumeration Date	:	08/29/2008
Last Update Date	:	09/29/2021

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