Provider Demographics
NPI:1588614481
Name:CRETE AREA MEDICAL CENTER
Entity type:Organization
Organization Name:CRETE AREA MEDICAL CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-826-2102
Mailing Address - Street 1:PO BOX 860873
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0873
Mailing Address - Country:US
Mailing Address - Phone:402-826-2102
Mailing Address - Fax:402-826-7950
Practice Address - Street 1:203 W 4TH ST
Practice Address - Street 2:
Practice Address - City:WILBER
Practice Address - State:NE
Practice Address - Zip Code:68465-2457
Practice Address - Country:US
Practice Address - Phone:402-821-3293
Practice Address - Fax:402-821-2450
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRETE AREA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-11
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025116800Medicaid
NE10025116800Medicaid
NE283469Medicare Oscar/Certification