Provider Demographics
NPI:1508956467
Name:FILLMORE COUNTY HOSPITAL
Entity Type:Organization
Organization Name:FILLMORE COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JEANNE
Authorized Official - Middle Name:L
Authorized Official - Last Name:ACKLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-759-3167
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:1900 F STREET
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-2229
Mailing Address - Country:US
Mailing Address - Phone:402-759-3167
Mailing Address - Fax:402-759-3505
Practice Address - Street 1:1900 F ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-2229
Practice Address - Country:US
Practice Address - Phone:402-759-3167
Practice Address - Fax:402-759-3505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE722207X00000X
NE192092084P0800X
NE192732084P0800X
NE232672085R0202X
NE289872085R0202X
NE256052085R0202X
NE280001282NC0060X
NE1324363A00000X
NE1228363AS0400X
NE111821363L00000X
NE110466363L00000X
NE11612363LP0808X
NE111110363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No282NC0060XHospitalsGeneral Acute Care HospitalCritical AccessGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgicalGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty