FAITH REGIONAL HEALTH SERVICES

Provider Demographics

• NPI: 1104854199
• Name: FAITH REGIONAL HEALTH SERVICES
• Entity type: Organization
• Organization Name: FAITH REGIONAL HEALTH SERVICES
• Other - Org Name: <UNAVAIL>
• Authorized Official - Title/Position: PRESIDENT/CEO
• Authorized Official - First Name: KELLY
• Authorized Official - Middle Name: A
• Authorized Official - Last Name: DRISCOLL
• Authorized Official - Phone: 402-371-4880
• Mailing Address - Street 1: PO BOX 869
• Mailing Address - City: NORFOLK
• Mailing Address - State: NE
• Mailing Address - Zip Code: 68702-0869
• Mailing Address - Country: US
• Mailing Address - Phone: 402-644-7249
• Mailing Address - Fax: 402-644-7432
• Practice Address - Street 1: 2700 W NORFOLK AVE
• Practice Address - City: NORFOLK
• Practice Address - State: NE
• Practice Address - Zip Code: 68701-4438
• Practice Address - Country: US
• Practice Address - Phone: 402-371-4880
• Practice Address - Fax: 402-644-7432
• EIN: <UNAVAIL>
• Is Organization Subpart?: Yes
• Parent Organization LBN: FAITH REGIONAL HEALTH SERVICES
• Parent Organization TIN: <UNAVAIL>
• Enumeration Date: 2006-06-29
• Last Update Date: 2021-07-28

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization	Group
Yes	207P00000X	Allopathic & Osteopathic Physicians	Emergency Medicine		Group - Multi-Specialty
No	101YA0400X	Behavioral Health & Social Service Providers	Counselor	Addiction (Substance Use Disorder)	Group - Multi-Specialty
No	104100000X	Behavioral Health & Social Service Providers	Social Worker		Group - Multi-Specialty
No	133V00000X	Dietary & Nutritional Service Providers	Dietitian, Registered		Group - Multi-Specialty
No	163WD0400X	Nursing Service Providers	Registered Nurse	Diabetes Educator	Group - Multi-Specialty
No	163WL0100X	Nursing Service Providers	Registered Nurse	Lactation Consultant	Group - Multi-Specialty
No	2084P0800X	Allopathic & Osteopathic Physicians	Psychiatry & Neurology	Psychiatry	Group - Multi-Specialty
No	208M00000X	Allopathic & Osteopathic Physicians	Hospitalist		Group - Multi-Specialty
No	225100000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Physical Therapist		Group - Multi-Specialty
No	225X00000X	Respiratory, Developmental, Rehabilitative and Restorative Service Providers	Occupational Therapist		Group - Multi-Specialty
No	235Z00000X	Speech, Language and Hearing Service Providers	Speech-Language Pathologist		Group - Multi-Specialty
No	332B00000X	Suppliers	Durable Medical Equipment & Medical Supplies		Group - Multi-Specialty
No	363A00000X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant		Group - Multi-Specialty
No	363AS0400X	Physician Assistants & Advanced Practice Nursing Providers	Physician Assistant	Surgical	Group - Multi-Specialty
No	363L00000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner		Group - Multi-Specialty

Provider Identifiers

State	Identifier ID	ID Type	Issuer
NE	31338	Other	BCBS ER GROUP
NE	10025533600	Medicaid
NE	36887	Other	BCBS DME
IA	0544858	Medicaid
NE	10025533500	Medicaid
NE	81002	Other	ZWIENER ONLY
IA	0538280	Medicaid
IA	0544858	Medicaid
NE	=========27	Medicaid
	=========002	Other	TRICARE ER GROUP
NE	=========32	Medicaid
NE	31338	Other	BCBS ER GROUP
NE	81002	Other	ZWIENER ONLY
NE	=========13	Medicaid
NE	=========63	Medicaid
NE	=========11	Medicaid
NE	81002	Other	ZWIENER ONLY
NE	=========13	Medicaid