Provider Demographics
NPI:1467652263
Name:GREATER SANDHILLS FAMILY HEALTHCARE, P.C.
Entity Type:Organization
Organization Name:GREATER SANDHILLS FAMILY HEALTHCARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ELAINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:402-924-3777
Mailing Address - Street 1:PO BOX 377
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:NE
Mailing Address - Zip Code:68780-0377
Mailing Address - Country:US
Mailing Address - Phone:256-508-7509
Mailing Address - Fax:402-924-3776
Practice Address - Street 1:110 W 2ND ST
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:NE
Practice Address - Zip Code:68780-1701
Practice Address - Country:US
Practice Address - Phone:402-924-3777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEPENDING261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE1508816083OtherNPI
NE1104812270OtherNPI
NE1598715633OtherNPI