Provider Demographics
NPI:1225058100
Name:COLUMBUS COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:COLUMBUS COMMUNITY HOSPITAL INC
Other - Org Name:OCCUPATIONAL HEALTH SERVICES OF COLUMBUS COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:VAN CLEAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-562-3357
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-564-7118
Mailing Address - Fax:402-562-3378
Practice Address - Street 1:3005 19TH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-4252
Practice Address - Country:US
Practice Address - Phone:402-562-4480
Practice Address - Fax:402-562-3267
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS COMMUNITY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099569Medicare PIN