Provider Demographics
NPI:1790783173
Name:THE WOMEN'S CENTER OF WESTERN NE PC
Entity Type:Organization
Organization Name:THE WOMEN'S CENTER OF WESTERN NE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-635-3033
Mailing Address - Street 1:3911 AVE B
Mailing Address - Street 2:SUITE 3100
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361
Mailing Address - Country:US
Mailing Address - Phone:308-635-3033
Mailing Address - Fax:308-635-3010
Practice Address - Street 1:3911 AVE B
Practice Address - Street 2:SUITE 3100
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361
Practice Address - Country:US
Practice Address - Phone:308-635-3033
Practice Address - Fax:308-635-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-11
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21009078452207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098831OtherMEDICARE ID
NE=========13Medicaid