MEDICARE: CITY OF GENOA

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	261QR1300X	Rural Health Clinic/Center

General Provider Information

NPI Number	:	1720505522
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF GENOA

Provider Business Mailing Address
First Line	:	PO BOX 425
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-0425
Country	:	US
Telephone Number	:	402-993-2206
Fax Number	:	402-993-2595

Provider Business Practice Location Address
First Line	:	505 S PARK ST
Second Line	:
City	:	GENOA
State	:	NE
Zip	:	68640-3036
Country	:	US
Telephone Number	:	402-993-2205
Fax Number	:	402-993-2595

Authorized Official
Title or Position	:	CEO
Name	:	AMANDA ROEBUCK
Credential	:
Telephone Number	:	402-993-4583

Provider Enumeration Date	:	08/23/2017
Last Update Date	:	01/23/2020

Similar Medicare Providers

1336127950 — MR. STEVE D WATTON PA C
Practice Location Address:

505 S PARK ST , PARK STREET MEDICAL CLINIC
GENOA, NE
68640-3036

Practice Phone: 402-993-2206
Practice Fax: 402-993-2595

1104859206 — CITY OF GENOA
Practice Location Address:

505 S PARK ST
GENOA, NE
68640-3036

Practice Phone: 402-993-2206
Practice Fax: 402-993-2595

1386077535 — MRS. JENNIFER LYNN SWANTEK APRN
Practice Location Address:

505 S PARK ST
GENOA, NE
68640-3036

Practice Phone: 402-993-2206
Practice Fax: 402-993-2595

1326723818 — JENNA PATRCIA ABRAMSON PA-C
Practice Location Address:

505 S PARK ST
GENOA, NE
68640-3036

Practice Phone: 402-993-2206
Practice Fax: 402-993-2595

1487621561 — CITY OF GENOA
Practice Location Address:

516 WILLARD AVE
GENOA, NE
68640-3039

Practice Phone: 402-572-4019
Practice Fax: 402-965-8594

1649228511 — CITY OF GENOA
Practice Location Address:

706 EWING ST
GENOA, NE
68640-3035

Practice Phone: 402-993-2283
Practice Fax: 402-993-2373

Directions to “CITY OF GENOA ” Practice Location

Language	Start Address	Practice Location

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