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
1	363A00000X	Physician Assistant
2	363LF0000X	Family Nurse Practitioner
3	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1629185350
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION

Provider Business Mailing Address
First Line	:	715 N SAINT JOSEPH AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-4497
Country	:	US
Telephone Number	:	402-463-4521
Fax Number	:	402-461-5321

Provider Business Practice Location Address
First Line	:	102 N PINE ST
Second Line	:
City	:	BLUE HILL
State	:	NE
Zip	:	68930-5532
Country	:	US
Telephone Number	:	402-756-2141
Fax Number	:	402-756-2142

Authorized Official
Title or Position	:	CEO
Name	:	MR. ERIC A BARBER
Credential	:
Telephone Number	:	402-461-5107

Provider Enumeration Date	:	08/25/2006
Last Update Date	:	03/31/2022

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