MEDICARE: COZAD COMMUNITY 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	282NC0060X	Critical Access Hospital	220001	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00103	OTHER	NE	BCBS OF NE PROVIDER #

General Provider Information

NPI Number	:	1881632883
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COZAD COMMUNITY HOSPITAL

Provider Business Mailing Address
First Line	:	PO BOX 108
Second Line	:
City	:	COZAD
State	:	NE
Zip	:	69130-0108
Country	:	US
Telephone Number	:	308-784-2261
Fax Number	:	308-784-4691

Provider Business Practice Location Address
First Line	:	300 E 12TH ST
Second Line	:
City	:	COZAD
State	:	NE
Zip	:	69130-1532
Country	:	US
Telephone Number	:	308-784-2261
Fax Number	:	308-784-4691

Authorized Official
Title or Position	:	CEO
Name	:	ROBERT J DYER
Credential	:
Telephone Number	:	308-784-2261

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/08/2022

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Directions to “COZAD COMMUNITY HOSPITAL ” Practice Location

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