MEDICARE: COLUMBUS COMMUNITY HOSPITAL INC

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	631001	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	00377	OTHER	NE	BCBS NE HOME HEALTH
2	F318	OTHER	NE	MIDLANDS CHOICE HHA

General Provider Information

NPI Number	:	1902893456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COLUMBUS COMMUNITY HOSPITAL INC

Provider Business Mailing Address
First Line	:	PO BOX 1800
Second Line	:
City	:	COLUMBUS
State	:	NE
Zip	:	68602-1800
Country	:	US
Telephone Number	:	402-564-7118
Fax Number	:	402-562-3378

Provider Business Practice Location Address
First Line	:	3005 19TH ST
Second Line	:	STE 600
City	:	COLUMBUS
State	:	NE
Zip	:	68601-4248
Country	:	US
Telephone Number	:	402-562-3300
Fax Number	:	402-562-4613

Authorized Official
Title or Position	:	VICE-PRESIDENT FINANCE
Name	:	MR. CHAD E VAN CLEAVE
Credential	:
Telephone Number	:	402-564-7118

Provider Enumeration Date	:	09/30/2005
Last Update Date	:	05/15/2015

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Directions to “COLUMBUS COMMUNITY HOSPITAL INC ” Practice Location

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