Provider Demographics
NPI:1619425121
Name:MIDTOWN HEALTH CENTER, INC.
Entity Type:Organization
Organization Name:MIDTOWN HEALTH CENTER, INC.
Other - Org Name:MIDTOWN HEALTH CENTER--NORFOLK AVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:NORDBY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-370-1060
Mailing Address - Street 1:302 W PHILLIP AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5248
Mailing Address - Country:US
Mailing Address - Phone:402-371-8000
Mailing Address - Fax:402-371-0971
Practice Address - Street 1:900 W NORFOLK AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5006
Practice Address - Country:US
Practice Address - Phone:402-371-8000
Practice Address - Fax:402-371-0971
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDTOWN HEALTH CENTER, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-09-13
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health