Provider Demographics
NPI:1417027210
Name:BROWN COUNTY HOSPITAL
Entity Type:Organization
Organization Name:BROWN COUNTY HOSPITAL
Other - Org Name:BCH PROFESSIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-387-2800
Mailing Address - Street 1:945 E ZERO ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69210-1556
Mailing Address - Country:US
Mailing Address - Phone:402-387-2800
Mailing Address - Fax:402-387-2804
Practice Address - Street 1:945 E ZERO ST
Practice Address - Street 2:
Practice Address - City:AINSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69210-1556
Practice Address - Country:US
Practice Address - Phone:402-387-2800
Practice Address - Fax:402-387-2804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWN COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE=========13Medicaid