Provider Demographics
NPI:1073626370
Name:CALLAWAY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CALLAWAY HOSPITAL DISTRICT
Other - Org Name:ARNOLD MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:D
Authorized Official - Last Name:EGGLESTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-836-2228
Mailing Address - Street 1:PO BOX 100
Mailing Address - Street 2:
Mailing Address - City:CALLAWAY
Mailing Address - State:NE
Mailing Address - Zip Code:68825-0100
Mailing Address - Country:US
Mailing Address - Phone:308-836-2228
Mailing Address - Fax:308-836-2733
Practice Address - Street 1:104 NORTH BROADWAY STREET
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:NE
Practice Address - Zip Code:69120-6351
Practice Address - Country:US
Practice Address - Phone:308-848-3259
Practice Address - Fax:308-848-3250
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CALLAWAY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-17
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025136200Medicaid
NE10025136200Medicaid