Provider Demographics
NPI:1457496481
Name:COMMUNITY MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:COMMUNITY MEDICAL CENTER, INC.
Other - Org Name:HOLT COUNTY FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PATTY
Authorized Official - Middle Name:
Authorized Official - Last Name:WINSLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-245-6532
Mailing Address - Street 1:2307 BARADA ST
Mailing Address - Street 2:PO BOX 399
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-1546
Mailing Address - Country:US
Mailing Address - Phone:402-245-4475
Mailing Address - Fax:402-245-6651
Practice Address - Street 1:101 SO. WASHINGTON ST.
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:MO
Practice Address - Zip Code:64473
Practice Address - Country:US
Practice Address - Phone:660-446-2090
Practice Address - Fax:660-446-2089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty