Provider Demographics
NPI:1649716143
Name:WEST HOLT MEMORIAL HOSPITAL
Entity type:Organization
Organization Name:WEST HOLT MEMORIAL HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-925-1947
Mailing Address - Street 1:406 W NEELY ST
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NE
Mailing Address - Zip Code:68713-4801
Mailing Address - Country:US
Mailing Address - Phone:402-925-2811
Mailing Address - Fax:402-925-2810
Practice Address - Street 1:313 W PEARL ST
Practice Address - Street 2:
Practice Address - City:ATKINSON
Practice Address - State:NE
Practice Address - Zip Code:68713-4958
Practice Address - Country:US
Practice Address - Phone:402-925-2651
Practice Address - Fax:402-925-2652
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WEST HOLT MEMORIAL HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-09
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy