Provider Demographics
NPI:1033318217
Name:GREATER SANDHILLS FAMILY HEALTHCARE, PC
Entity Type:Organization
Organization Name:GREATER SANDHILLS FAMILY HEALTHCARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-924-3777
Mailing Address - Street 1:PO BOX 70
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:NE
Mailing Address - Zip Code:68780-0070
Mailing Address - Country:US
Mailing Address - Phone:402-924-3660
Mailing Address - Fax:402-924-3776
Practice Address - Street 1:110 W 2ND STREET
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:NE
Practice Address - Zip Code:68780-1701
Practice Address - Country:US
Practice Address - Phone:402-924-3777
Practice Address - Fax:402-924-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1025535800Medicaid
NE099996Medicare PIN