Provider Demographics
NPI:1336205343
Name:OAKLAND MERCY HOSPITAL
Entity Type:Organization
Organization Name:OAKLAND MERCY HOSPITAL
Other - Org Name:MERCYONE OAKLAND MEDICAL CENTER-PROFESSIONAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO AND ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VLACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-685-5601
Mailing Address - Street 1:601 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68045-1400
Mailing Address - Country:US
Mailing Address - Phone:402-685-5601
Mailing Address - Fax:402-685-6223
Practice Address - Street 1:601 E 2ND ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NE
Practice Address - Zip Code:68045-1400
Practice Address - Country:US
Practice Address - Phone:402-685-5601
Practice Address - Fax:402-685-6223
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OAKLAND MERCY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-28
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099900Medicare PIN