Provider Demographics
NPI:1598869240
Name:COLUMBUS COMMUNITY HOSPITAL INC
Entity Type:Organization
Organization Name:COLUMBUS COMMUNITY HOSPITAL INC
Other - Org Name:COLUMBUS COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:VAN CLEAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-564-7118
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-564-7118
Mailing Address - Fax:402-562-3378
Practice Address - Street 1:4600 38TH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NE
Practice Address - Zip Code:68601-1664
Practice Address - Country:US
Practice Address - Phone:402-564-7118
Practice Address - Fax:402-562-3378
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS COMMUNITY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE630001275N00000X
NELTCH007314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00162OtherBCBS NE SNF
NE28U111Medicare Oscar/Certification