Provider Demographics
NPI:1477845774
Name:COZAD COMMUNITY HOSPITAL
Entity Type:Organization
Organization Name:COZAD COMMUNITY HOSPITAL
Other - Org Name:CENTRAL PLAINS HOME HEALTH AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GEARHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-784-2261
Mailing Address - Street 1:835 MERIDIAN AVE
Mailing Address - Street 2:
Mailing Address - City:COZAD
Mailing Address - State:NE
Mailing Address - Zip Code:69130-1754
Mailing Address - Country:US
Mailing Address - Phone:308-784-4630
Mailing Address - Fax:308-784-4635
Practice Address - Street 1:835 MERIDIAN AVE
Practice Address - Street 2:
Practice Address - City:COZAD
Practice Address - State:NE
Practice Address - Zip Code:69130-1754
Practice Address - Country:US
Practice Address - Phone:308-784-4630
Practice Address - Fax:308-784-4635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE221001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE94031195Medicaid