Provider Demographics
NPI:1588685531
Name:ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER
Entity Type:Organization
Organization Name:ALEGENT HEALTH-MEMORIAL HOSPITAL SCHUYLER
Other - Org Name:ALLEGENT HEALTH MEMORIAL HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO - CHI HEALTH
Authorized Official - Prefix:
Authorized Official - First Name:EVERT
Authorized Official - Middle Name:
Authorized Official - Last Name:KUIPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-343-4420
Mailing Address - Street 1:104 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:SCHUYLER
Mailing Address - State:NE
Mailing Address - Zip Code:68661-1304
Mailing Address - Country:US
Mailing Address - Phone:402-352-2441
Mailing Address - Fax:402-352-2643
Practice Address - Street 1:104 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SCHUYLER
Practice Address - State:NE
Practice Address - Zip Code:68661-1304
Practice Address - Country:US
Practice Address - Phone:402-352-4067
Practice Address - Fax:402-352-2643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
NE26083336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2054719OtherPK
NE=========00Medicaid