Provider Demographics
NPI:1679685291
Name:MOSCATI HEALTH CENTER PC
Entity Type:Organization
Organization Name:MOSCATI HEALTH CENTER PC
Other - Org Name:MOSCATI HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:SKOCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-463-2929
Mailing Address - Street 1:PO BOX 1423
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68902-1423
Mailing Address - Country:US
Mailing Address - Phone:402-463-2929
Mailing Address - Fax:402-463-2939
Practice Address - Street 1:223 E 14TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-3200
Practice Address - Country:US
Practice Address - Phone:402-463-2929
Practice Address - Fax:402-463-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========13Medicaid
NE=========26Medicaid
NE=========26Medicaid
NE=========13Medicaid