Provider Demographics
NPI:1700908167
Name:CHADRON COMMUNITY HOSPITAL CORP.
Entity Type:Organization
Organization Name:CHADRON COMMUNITY HOSPITAL CORP.
Other - Org Name:PRAIRIE PINES LODGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-432-5586
Mailing Address - Street 1:821 MOREHEAD ST
Mailing Address - Street 2:
Mailing Address - City:CHADRON
Mailing Address - State:NE
Mailing Address - Zip Code:69337-2546
Mailing Address - Country:US
Mailing Address - Phone:308-432-5586
Mailing Address - Fax:308-432-2737
Practice Address - Street 1:900 W 7TH ST
Practice Address - Street 2:
Practice Address - City:CHADRON
Practice Address - State:NE
Practice Address - Zip Code:69337-2500
Practice Address - Country:US
Practice Address - Phone:308-432-4305
Practice Address - Fax:308-432-8996
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHADRON COMMUNITY HOSPITAL CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-05
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========01Medicaid