Provider Demographics
NPI:1669429635
Name:COMMUNITY MEDICAL CENTER, INC.
Entity type:Organization
Organization Name:COMMUNITY MEDICAL CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-245-2428
Mailing Address - Street 1:3307 BILL SCHOCK BLVD
Mailing Address - Street 2:
Mailing Address - City:FALLS CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68355-2428
Mailing Address - Country:US
Mailing Address - Phone:402-245-6500
Mailing Address - Fax:402-245-6645
Practice Address - Street 1:3307 BILL SCHOCK BLVD
Practice Address - Street 2:
Practice Address - City:FALLS CITY
Practice Address - State:NE
Practice Address - Zip Code:68355-2428
Practice Address - Country:US
Practice Address - Phone:402-245-2428
Practice Address - Fax:402-245-6645
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMMUNITY MEDICAL CENTER, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-27
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE66001275N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes275N00000XHospital UnitsMedicare Defined Swing Bed Unit
Provider Identifiers
StateIdentifier IDID TypeIssuer
28Z352Medicare Oscar/Certification