Provider Demographics
NPI:1396961645
Name:MORRILL COUNTY COMMUNITY HOSPITAL
Entity type:Organization
Organization Name:MORRILL COUNTY COMMUNITY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:STUART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-262-1616
Mailing Address - Street 1:1313 S ST
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:NE
Mailing Address - Zip Code:69336-2563
Mailing Address - Country:US
Mailing Address - Phone:308-262-1616
Mailing Address - Fax:308-262-0843
Practice Address - Street 1:1313 S ST
Practice Address - Street 2:STE A
Practice Address - City:BRIDGEPORT
Practice Address - State:NE
Practice Address - Zip Code:69336-2563
Practice Address - Country:US
Practice Address - Phone:308-262-1755
Practice Address - Fax:308-262-0765
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MORRILL COUNTY COMMUNITY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-17
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE03456OtherBCBS OF NEBRASKA
NE03456OtherBCBS OF NEBRASKA
NE03456OtherBCBS OF NEBRASKA
NECF8681Medicare PIN