Provider Demographics
NPI:1720188139
Name:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Entity Type:Organization
Organization Name:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOHRMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-747-2031
Mailing Address - Street 1:PO BOX 428
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:NE
Mailing Address - Zip Code:68651-0428
Mailing Address - Country:US
Mailing Address - Phone:402-747-2031
Mailing Address - Fax:402-747-1405
Practice Address - Street 1:531 BEEBE ST
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:NE
Practice Address - Zip Code:68651-5537
Practice Address - Country:US
Practice Address - Phone:402-747-2031
Practice Address - Fax:402-747-1405
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ANNIE JEFFREY MEMORIAL COUNTY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE640001275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00343OtherBCBS OF NEBRASKA
NE00343OtherBCBS OF NEBRASKA
NE=========00Medicaid