MEDICARE: JOHNSON COUNTY HOSPITAL

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	251E00000X	Home Health Agency	451001	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00419	OTHER	NE	BCBS OF NEBRASKA

General Provider Information

NPI Number	:	1821001405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHNSON COUNTY HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 599
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-0599
Country	:	US
Telephone Number	:	404-335-3371
Fax Number	:	402-335-3447

Provider Business Practice Location Address
First Line	:	202 HIGH ST
Second Line	:
City	:	TECUMSEH
State	:	NE
Zip	:	68450-2443
Country	:	US
Telephone Number	:	402-335-3361
Fax Number	:	402-335-6342

Authorized Official
Title or Position	:	CEO
Name	:	MARY JANE KENT
Credential	:
Telephone Number	:	402-335-3361

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	11/08/2022

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Directions to “JOHNSON COUNTY HOSPITAL ” Practice Location

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