Provider Demographics
NPI:1760464283
Name:BROWN COUNTY HOSPITAL
Entity Type:Organization
Organization Name:BROWN COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-387-2800
Mailing Address - Street 1:945 E ZERO ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69210-1556
Mailing Address - Country:US
Mailing Address - Phone:402-387-2800
Mailing Address - Fax:402-387-2804
Practice Address - Street 1:945 E ZERO ST
Practice Address - Street 2:
Practice Address - City:AINSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69210-1556
Practice Address - Country:US
Practice Address - Phone:402-387-2800
Practice Address - Fax:402-387-2804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-18
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE060001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0136OtherBCBS
006895400OtherFEDERAL BLACK LUNG PROGRA
006895400OtherFEDERAL BLACK LUNG PROGRA
NE=========00Medicaid