Provider Demographics
NPI:1114922259
Name:ROCK COUNTY HOSPITAL
Entity Type:Organization
Organization Name:ROCK COUNTY HOSPITAL
Other - Org Name:ROCK COUNTY HOSPITAL LONG TERM CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-684-2991
Mailing Address - Street 1:102 E SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-5512
Mailing Address - Country:US
Mailing Address - Phone:402-684-3366
Mailing Address - Fax:402-684-3677
Practice Address - Street 1:100 E SOUTH ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-5511
Practice Address - Country:US
Practice Address - Phone:402-684-2991
Practice Address - Fax:402-684-3825
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROCK COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-16
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========11Medicaid