Provider Demographics
NPI:1285677633
Name:COZAD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:COZAD COMMUNITY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:DYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-784-2261
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-0108
Mailing Address - Country:US
Mailing Address - Phone:308-784-2261
Mailing Address - Fax:308-784-4691
Practice Address - Street 1:300 E 12TH ST
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130-1532
Practice Address - Country:US
Practice Address - Phone:308-784-2261
Practice Address - Fax:308-784-4691
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COZAD COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-14
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE220001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00280OtherBCBS OF NE PROV #
NE28Z327Medicare Oscar/Certification