Provider Demographics
NPI:1568520450
Name:FAMILY HEALTH CARE OF COLUMBUS P.C.
Entity Type:Organization
Organization Name:FAMILY HEALTH CARE OF COLUMBUS P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOERING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-564-9575
Mailing Address - Street 1:2485 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68601-2256
Mailing Address - Country:US
Mailing Address - Phone:402-564-9575
Mailing Address - Fax:402-562-7472
Practice Address - Street 1:2485 39TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-2256
Practice Address - Country:US
Practice Address - Phone:402-564-9575
Practice Address - Fax:402-562-7472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE18870261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE50860556808Medicaid
NE00334OtherBCBS NE
NE270540Medicare ID - Type UnspecifiedMEDICARE
NE50860556808Medicaid