Provider Demographics
NPI:1598848723
Name:WEST HOLT MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:WEST HOLT MEMORIAL HOSPITAL
Other - Org Name:BASSETT FAMILY CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:A
Authorized Official - Last Name:LINSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-925-2811
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NE
Mailing Address - Zip Code:68713-0458
Mailing Address - Country:US
Mailing Address - Phone:402-684-3245
Mailing Address - Fax:402-684-3246
Practice Address - Street 1:103 CLARK ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-6012
Practice Address - Country:US
Practice Address - Phone:402-684-3245
Practice Address - Fax:402-684-3246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-23
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========Medicaid
283492Medicare UPIN
0402720001Medicare NSC