Basic Information
Provider Information
NPI: 1033698543
EntityType: 2
ReplacementNPI:  
OrganizationName: METHODIST FREMONT HEALTH
LastName:  
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Mailing Information
Address1: 450 E 23RD ST
Address2:  
City: FREMONT
State: NE
PostalCode: 680252387
CountryCode: US
TelephoneNumber: 4027211610
FaxNumber: 4027273433
Practice Location
Address1: 450 E 23RD ST
Address2:  
City: FREMONT
State: NE
PostalCode: 680252387
CountryCode: US
TelephoneNumber: 4027211610
FaxNumber: 4027273433
Other Information
ProviderEnumerationDate: 08/07/2018
LastUpdateDate: 11/23/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: RICHMOND
AuthorizedOfficialFirstName: BRETT
AuthorizedOfficialMiddleName: M
AuthorizedOfficialTitleorPosition: PRESIDENT & CEO
AuthorizedOfficialTelephone: 4027211610
IsSoleProprietor:  
IsOrganizationSubpart: N
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NPICertificationDate: 11/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
282NR1301X  Y HospitalsGeneral Acute Care HospitalRural

No ID Information.


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