Provider Demographics
NPI:1588812796
Name:THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION
Other - Org Name:MLH MEDICAL ONCOLOGY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:A
Authorized Official - Last Name:BARBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-461-5108
Mailing Address - Street 1:815 N KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-4470
Mailing Address - Country:US
Mailing Address - Phone:402-460-5899
Mailing Address - Fax:
Practice Address - Street 1:815 N KANSAS AVE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-4470
Practice Address - Country:US
Practice Address - Phone:402-460-5899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MARY LANNING MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NENA1137Medicare PIN