Provider Demographics
NPI:1841240744
Name:CRETE AREA MEDICAL CENTER
Entity Type:Organization
Organization Name:CRETE AREA MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOLDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-826-2102
Mailing Address - Street 1:PO BOX 220
Mailing Address - Street 2:
Mailing Address - City:CRETE
Mailing Address - State:NE
Mailing Address - Zip Code:68333-0220
Mailing Address - Country:US
Mailing Address - Phone:402-826-2102
Mailing Address - Fax:402-826-7950
Practice Address - Street 1:2910 BETTEN DR
Practice Address - Street 2:
Practice Address - City:CRETE
Practice Address - State:NE
Practice Address - Zip Code:68333-3084
Practice Address - Country:US
Practice Address - Phone:402-826-2102
Practice Address - Fax:402-826-7950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRETE AREA MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-11
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025113200Medicaid
NE10025113200Medicaid