Provider Demographics
NPI: | 1356656417 |
---|---|
Name: | THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION |
Entity type: | Organization |
Organization Name: | THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ERIC |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | BARBER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 402-461-5108 |
Mailing Address - Street 1: | 715 NORTH ST. JOSEPH AVENUE |
Mailing Address - Street 2: | |
Mailing Address - City: | HASTINGS |
Mailing Address - State: | NE |
Mailing Address - Zip Code: | 68901-4497 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 402-463-4521 |
Mailing Address - Fax: | 402-461-5321 |
Practice Address - Street 1: | 715 N SAINT JOSEPH AVE |
Practice Address - Street 2: | |
Practice Address - City: | HASTINGS |
Practice Address - State: | NE |
Practice Address - Zip Code: | 68901-4497 |
Practice Address - Country: | US |
Practice Address - Phone: | 402-463-4521 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | Yes |
Parent Organization LBN: | THE MARY LANNING MEMORIAL HOSPITAL ASSOCIATION |
Parent Organization TIN: | <UNAVAIL> |
Enumeration Date: | 2010-08-13 |
Last Update Date: | 2022-10-19 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
No | 207L00000X | Allopathic & Osteopathic Physicians | Anesthesiology | Group - Multi-Specialty | |
No | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | Group - Multi-Specialty | |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
No | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Group - Multi-Specialty | |
No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
No | 208600000X | Allopathic & Osteopathic Physicians | Surgery | Group - Multi-Specialty | |
No | 208800000X | Allopathic & Osteopathic Physicians | Urology | Group - Multi-Specialty | |
No | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist | Group - Multi-Specialty | |
No | 208VP0000X | Allopathic & Osteopathic Physicians | Pain Medicine | Pain Medicine | Group - Multi-Specialty |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
NE | NA1676 | Medicare PIN |