Provider Demographics
NPI:1013087089
Name:MEMORIAL HEALTH CARE SYSTEMS
Entity Type:Organization
Organization Name:MEMORIAL HEALTH CARE SYSTEMS
Other - Org Name:MEMORIAL HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-646-4628
Mailing Address - Street 1:300 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2299
Mailing Address - Country:US
Mailing Address - Phone:402-646-4628
Mailing Address - Fax:402-646-4605
Practice Address - Street 1:300 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2299
Practice Address - Country:US
Practice Address - Phone:402-643-2971
Practice Address - Fax:402-646-4605
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MEMORIAL HEALTH CARE SYSTEMS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-11-08
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE720001275N00000X, 282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
No282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00502OtherSWING-BED (BCBS OF NE)
NE00502OtherSWING-BED (BCBS OF NE)
NE28Z339Medicare Oscar/Certification