Provider Demographics
NPI:1790866762
Name:PANHANDLE HEALTH SERVICE
Entity Type:Organization
Organization Name:PANHANDLE HEALTH SERVICE
Other - Org Name:PARTNER IN BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CURT
Authorized Official - Middle Name:
Authorized Official - Last Name:COPPLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-630-1115
Mailing Address - Street 1:2 W 42ND ST
Mailing Address - Street 2:SUITE 3200
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-4669
Mailing Address - Country:US
Mailing Address - Phone:308-630-1115
Mailing Address - Fax:308-630-1817
Practice Address - Street 1:2 W 42ND ST
Practice Address - Street 2:SUITE 3200
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-4669
Practice Address - Country:US
Practice Address - Phone:308-630-1115
Practice Address - Fax:308-630-1817
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGIONAL WEST HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-18
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
098511OtherMEDICARE
CC9608OtherRR MEDICARE