Provider Demographics
NPI:1689756561
Name:FILLMORE COUNTY HOSPITAL
Entity Type:Organization
Organization Name:FILLMORE COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-759-3167
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NE
Mailing Address - Zip Code:68361-0193
Mailing Address - Country:US
Mailing Address - Phone:402-759-3167
Mailing Address - Fax:402-759-3505
Practice Address - Street 1:1900 F ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NE
Practice Address - Zip Code:68361-2229
Practice Address - Country:US
Practice Address - Phone:402-759-3167
Practice Address - Fax:402-759-3505
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FILLMORE COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEH42OtherMIDLANDS CHOICE SWING BED
NE00345OtherBCBS SWING BED
NE00345OtherBCBS SWING BED
NE=========01Medicaid
NEH42OtherMIDLANDS CHOICE SWING BED