Provider Demographics
NPI:1558384842
Name:TILDEN COMMUNITY HOSPITAL & RURAL HEALTH CLINIC
Entity Type:Organization
Organization Name:TILDEN COMMUNITY HOSPITAL & RURAL HEALTH CLINIC
Other - Org Name:TCH MEDICAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-368-5343
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:308 WEST 2ND
Mailing Address - City:TILDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68781-0220
Mailing Address - Country:US
Mailing Address - Phone:402-368-9964
Mailing Address - Fax:402-368-5675
Practice Address - Street 1:306 W 2ND ST
Practice Address - Street 2:
Practice Address - City:TILDEN
Practice Address - State:NE
Practice Address - Zip Code:68781-4760
Practice Address - Country:US
Practice Address - Phone:402-368-9964
Practice Address - Fax:402-368-5675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025355300Medicaid
NE10025300500Medicaid
NE283487Medicare ID - Type UnspecifiedRURAL HEALTH
NE10025355300Medicaid