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NPI Code Detail

MEDICARE: PROVIDENCE MEDICAL CENTER

MEDICARE: PROVIDENCE MEDICAL CENTER
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
1282NC0060XCritical Access Hospital800001NE
2282NC0060XCritical Access HospitalNE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801867494
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROVIDENCE MEDICAL CENTER
Provider Business Mailing Address
First Line : 1200 PROVIDENCE ROAD
Second Line :
City : WAYNE
State : NE
Zip : 68787-1212
Country : US
Telephone Number : 402-375-7960
Fax Number : 402-375-7989
Provider Business Practice Location Address
First Line : 1200 PROVIDENCE ROAD
Second Line :
City : WAYNE
State : NE
Zip : 68787-1212
Country : US
Telephone Number : 402-375-7960
Fax Number : 402-375-7989
Authorized Official
Title or Position : CEO
Name : MS. NICOLE HAGLUND
Credential :
Telephone Number : 402-375-7954
Provider Enumeration Date : 01/31/2006
Last Update Date : 03/11/2025

Similar Medicare Providers

1255470092 — PROVIDENCE MEDICAL CENTER
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-3800
Practice Fax: 402-375-7989
1477811065 — ANDREA JOHNSON PT, DPT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax: 402-375-7956
1093073694 — JEAN ANN HARROLD-LOBERG P.T.
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax:
1558629154 — MOLLY MARIE REDDEN PT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax:
1114285798 — MISS DAWN MONIQUE ADDISON-CORBIT PT,DPT
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-7937
Practice Fax: 402-375-7956
1598134751 — MORGAN EBBERSON
Practice Location Address:
1200 PROVIDENCE RD
WAYNE, NE
68787-1212
Practice Phone: 402-375-3800
Practice Fax:

Directions to “PROVIDENCE MEDICAL CENTER ” Practice Location

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