Provider Demographics
NPI:1891763512
Name:BROWN COUNTY HOSPITAL
Entity Type:Organization
Organization Name:BROWN COUNTY HOSPITAL
Other - Org Name:BROWN COUNTY HOSPITAL HOME HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MIRYA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-387-2800
Mailing Address - Street 1:945 E ZERO ST
Mailing Address - Street 2:
Mailing Address - City:AINSWORTH
Mailing Address - State:NE
Mailing Address - Zip Code:69210-1556
Mailing Address - Country:US
Mailing Address - Phone:402-387-2800
Mailing Address - Fax:402-387-2804
Practice Address - Street 1:945 E ZERO ST
Practice Address - Street 2:
Practice Address - City:AINSWORTH
Practice Address - State:NE
Practice Address - Zip Code:69210-1556
Practice Address - Country:US
Practice Address - Phone:402-387-2800
Practice Address - Fax:402-387-2804
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROWN COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-09
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE061001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE0645OtherBCBS
NE0645OtherBCBS
NE287112Medicare Oscar/Certification