Basic Information
| Provider Information | |||||||||
| NPI: | 1922111855 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | BCHHC PROFESSIONAL SERVICES | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| 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: | 683106906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4022283344 | ||||||||
| FaxNumber: | 4022237299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/16/2006 | ||||||||
| LastUpdateDate: | 02/15/2017 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | FINDLEY | ||||||||
| AuthorizedOfficialFirstName: | JOHN | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | INTERIM CEO | ||||||||
| AuthorizedOfficialTelephone: | 4022236778 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | BEATRICE COMMUNITY HOSPITAL & HEALTH CENTER | ||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207V00000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 208000000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | 133NN1002X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Dietary & Nutritional Service Providers | Nutritionist | Nutrition, Education | 367A00000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367500000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 363A00000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | H000119 | NE | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207P00000X | H000119 | NE | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 81023 | 01 | NE | BC DIABETIC PROVIDER # | OTHER | 08526 | 01 | NE | BC CRNA PROVIDER # | OTHER | 100206970B | 05 | KS | MEDICAID | 01611 | 01 | NE | BC PRO FEE PROVIDER # | OTHER |