Basic Information
Provider Information | |||||||||
NPI: | 1871088237 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: | BCHHC MDPP | ||||||||
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 PKWY | ||||||||
Address2: |   | ||||||||
City: | BEATRICE | ||||||||
State: | NE | ||||||||
PostalCode: | 683106906 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 4022283344 | ||||||||
FaxNumber: | 4022237299 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 06/28/2018 | ||||||||
LastUpdateDate: | 06/28/2018 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | STREETER | ||||||||
AuthorizedOfficialFirstName: | ALAN | ||||||||
AuthorizedOfficialMiddleName: | W | ||||||||
AuthorizedOfficialTitleorPosition: | CFO | ||||||||
AuthorizedOfficialTelephone: | 4022237224 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | Y | ||||||||
ParentOrganizationLBN: | BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282NC0060X | H000119 | NE | Y |   | Hospitals | General Acute Care Hospital | Critical Access |
ID Information
ID | Type | State | Issuer | Description | 6639196 | 01 |   | CDC DIABETES PREVENTION PROGRAM STANDARDS AND OPERATING PROCEDURE | OTHER |