Provider Demographics
NPI:1124186846
Name:CHASE COUNTY COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:CHASE COUNTY COMMUNITY HOSPITAL
Other - Org Name:CHASE COUNTY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CYBORON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-882-7111
Mailing Address - Street 1:600 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL
Mailing Address - State:NE
Mailing Address - Zip Code:69033-3131
Mailing Address - Country:US
Mailing Address - Phone:308-882-7299
Mailing Address - Fax:308-882-7362
Practice Address - Street 1:600 W 12TH ST
Practice Address - Street 2:
Practice Address - City:IMPERIAL
Practice Address - State:NE
Practice Address - Zip Code:69033-3131
Practice Address - Country:US
Practice Address - Phone:308-882-7299
Practice Address - Fax:308-882-7362
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHASE COUNTY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-05
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE283490Medicare Oscar/Certification