Basic Information
Provider Information
NPI: 1588002422
EntityType: 2
ReplacementNPI:  
OrganizationName: BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BEATRICE FAMILY AND INTERNAL MEDICINE
OtherOrganizationType: 5
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 278
Address2:  
City: BEATRICE
State: NE
PostalCode: 683100278
CountryCode: US
TelephoneNumber: 4022283344
FaxNumber: 4022237299
Practice Location
Address1: 4800 HOSPITAL PARKWAY
Address2:  
City: BEATRICE
State: NE
PostalCode: 683100278
CountryCode: US
TelephoneNumber: 4022232366
FaxNumber: 4022283502
Other Information
ProviderEnumerationDate: 06/13/2013
LastUpdateDate: 05/07/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JURGENS
AuthorizedOfficialFirstName: CHAD
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CFO
AuthorizedOfficialTelephone: 4022237224
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER, INC
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/07/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
261Q00000X  N Ambulatory Health Care FacilitiesClinic/Center 
261QR1300X  Y Ambulatory Health Care FacilitiesClinic/CenterRural Health

No ID Information.


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