Provider Demographics
NPI:1275544017
Name:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Other - Org Name:ANNIE JEFFREY FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-747-2031
Mailing Address - Street 1:PO BOX 546
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:NE
Mailing Address - Zip Code:68651-0546
Mailing Address - Country:US
Mailing Address - Phone:402-747-8851
Mailing Address - Fax:402-747-1407
Practice Address - Street 1:531 BEEBE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:NE
Practice Address - Zip Code:68651-5537
Practice Address - Country:US
Practice Address - Phone:402-747-8851
Practice Address - Fax:402-747-1407
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========12Medicaid
NE098523Medicare PIN