Provider Demographics
NPI:1356676761
Name:OAKLAND MERCY HOSPITAL
Entity Type:Organization
Organization Name:OAKLAND MERCY HOSPITAL
Other - Org Name:HOOPER MERCY MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-685-5601
Mailing Address - Street 1:601 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68045-1400
Mailing Address - Country:US
Mailing Address - Phone:402-685-5601
Mailing Address - Fax:402-685-6223
Practice Address - Street 1:600 E FULTON ST
Practice Address - Street 2:
Practice Address - City:HOOPER
Practice Address - State:NE
Practice Address - Zip Code:68031-3074
Practice Address - Country:US
Practice Address - Phone:402-685-7580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKLAND MERCY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-10-03
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE283871Medicare Oscar/Certification