Provider Demographics
NPI:1164691531
Name:BOX BUTTE GENERAL HOSPITAL
Entity Type:Organization
Organization Name:BOX BUTTE GENERAL HOSPITAL
Other - Org Name:GREATER NEBRASKA MEDICAL & SURGICAL SERVICES - ALLIANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:GRIESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-762-6660
Mailing Address - Street 1:PO BOX 810
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:NE
Mailing Address - Zip Code:69301-0810
Mailing Address - Country:US
Mailing Address - Phone:308-762-6660
Mailing Address - Fax:308-762-1923
Practice Address - Street 1:2091 BOX BUTTE AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:ALLIANCE
Practice Address - State:NE
Practice Address - Zip Code:69301-4452
Practice Address - Country:US
Practice Address - Phone:308-762-7244
Practice Address - Fax:308-762-6657
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BOX BUTTE GENERAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-02-29
Last Update Date:2014-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025651800Medicaid
NE10025651800Medicaid