Provider Demographics
NPI:1225658495
Name:GRAND ISLAND REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:GRAND ISLAND REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPEICHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-675-5000
Mailing Address - Street 1:PO BOX 5225
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68802-5225
Mailing Address - Country:US
Mailing Address - Phone:308-675-5000
Mailing Address - Fax:
Practice Address - Street 1:3533 PRAIRIEVIEW ST.
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68802-5225
Practice Address - Country:US
Practice Address - Phone:308-675-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-17
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty