Provider Demographics
NPI:1851345573
Name:PAWNEE COUNTY MEMORIAL HOSPITAL
Entity Type:Organization
Organization Name:PAWNEE COUNTY MEMORIAL HOSPITAL
Other - Org Name:PAWNEE COUNTY RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:STEPHENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-852-2311
Mailing Address - Street 1:600 I ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68420-3001
Mailing Address - Country:US
Mailing Address - Phone:402-852-2311
Mailing Address - Fax:402-852-2170
Practice Address - Street 1:600 I ST
Practice Address - Street 2:
Practice Address - City:PAWNEE CITY
Practice Address - State:NE
Practice Address - Zip Code:68420-3001
Practice Address - Country:US
Practice Address - Phone:402-852-2311
Practice Address - Fax:402-852-2170
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PAWNEE COUNTY MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-19
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE590001261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE086036OtherMEDICARE GROUP NO.
NE=========19Medicaid
NE=========12Medicaid
NE=========12Medicaid