Provider Demographics
NPI:1205977873
Name:KEARNEY CO HEALTH SERVICES
Entity type:Organization
Organization Name:KEARNEY CO HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:D
Authorized Official - Last Name:POORE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-832-3400
Mailing Address - Street 1:727 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68959-1705
Mailing Address - Country:US
Mailing Address - Phone:308-832-3400
Mailing Address - Fax:308-832-3414
Practice Address - Street 1:727 E 1ST ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NE
Practice Address - Zip Code:68959-1705
Practice Address - Country:US
Practice Address - Phone:308-832-3400
Practice Address - Fax:308-832-3414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KEARNEY CO HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-08
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural HealthGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE098182Medicare PIN
NE283416Medicare Oscar/Certification
NE098182Medicare ID - Type UnspecifiedRHC MEDICARE PART B