Provider Demographics
NPI:1093758740
Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:FRANKLIN COUNTY MEMORIAL HOSPITAL
Other - Org Name:FCMH CAMPBELL MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIZZO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-425-6221
Mailing Address - Street 1:1406 Q ST
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NE
Mailing Address - Zip Code:68939-1073
Mailing Address - Country:US
Mailing Address - Phone:308-425-6221
Mailing Address - Fax:308-425-3164
Practice Address - Street 1:148 SOUTH TAYLOR STREET
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:NE
Practice Address - Zip Code:68932
Practice Address - Country:US
Practice Address - Phone:402-756-8080
Practice Address - Fax:402-756-8080
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANKLIN COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-13
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
283400Medicare Oscar/Certification