Provider Demographics
NPI:1841204500
Name:COMMUNITY HOSPITAL ASSOCIATION
Entity Type:Organization
Organization Name:COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:COMMUNITY HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-344-8315
Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-1328
Mailing Address - Country:US
Mailing Address - Phone:308-344-8303
Mailing Address - Fax:308-344-8572
Practice Address - Street 1:1301 E H ST
Practice Address - Street 2:
Practice Address - City:MCCOOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3482
Practice Address - Country:US
Practice Address - Phone:308-344-2650
Practice Address - Fax:308-344-8358
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE320007282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0041OtherBLUE CROSS
KS100099690AMedicaid
NE=========00Medicaid
NE281363Medicare Oscar/Certification