Provider Demographics
NPI:1841383148
Name:JOHNSON COUNTY HOSPITAL
Entity Type:Organization
Organization Name:JOHNSON COUNTY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-335-3361
Mailing Address - Street 1:PO BOX 599
Mailing Address - Street 2:
Mailing Address - City:TECUMSEH
Mailing Address - State:NE
Mailing Address - Zip Code:68450-0599
Mailing Address - Country:US
Mailing Address - Phone:402-335-3361
Mailing Address - Fax:402-335-6342
Practice Address - Street 1:202 HIGH STREET
Practice Address - Street 2:
Practice Address - City:TECUMSEH
Practice Address - State:NE
Practice Address - Zip Code:68450-2443
Practice Address - Country:US
Practice Address - Phone:402-335-3361
Practice Address - Fax:402-335-6342
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE450001275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00441OtherBCBS OF NEBRASKA
NE00441OtherBCBS OF NEBRASKA
NE=========00Medicaid
NE28Z350Medicare Oscar/Certification