Provider Demographics
NPI:1033218037
Name:CHERRY COUNTY HOSPITAL
Entity Type:Organization
Organization Name:CHERRY COUNTY HOSPITAL
Other - Org Name:CHERRY COUNTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-376-2525
Mailing Address - Street 1:510 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-1932
Mailing Address - Country:US
Mailing Address - Phone:402-376-2525
Mailing Address - Fax:402-376-1627
Practice Address - Street 1:512 NORTH GREEN ST
Practice Address - Street 2:
Practice Address - City:VALENTINE
Practice Address - State:NE
Practice Address - Zip Code:69201-1982
Practice Address - Country:US
Practice Address - Phone:402-376-3770
Practice Address - Fax:402-376-3779
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHERRY COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025198500Medicaid
NE346235000Medicaid
SD5340250Medicaid
NE10024984900Medicaid
NE283477Medicare Oscar/Certification
NEDA1524Medicare ID - Type UnspecifiedRAILROAD
NE4851690001Medicare NSC
NE099337Medicare PIN