Provider Demographics
NPI:1740384312
Name:FAITH REGIONAL HEALTH SERVICES
Entity type:Organization
Organization Name:FAITH REGIONAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:SINEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-644-7468
Mailing Address - Street 1:PO BOX 869
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68702-0869
Mailing Address - Country:US
Mailing Address - Phone:402-644-7144
Mailing Address - Fax:402-644-7432
Practice Address - Street 1:1603 W PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-3683
Practice Address - Country:US
Practice Address - Phone:402-644-7592
Practice Address - Fax:402-644-7464
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FAITH REGIONAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-12
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEESRD015261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5530790Medicaid
NE5000020OtherUNITED HEALTHCARE ESRD
NE0006400415OtherAETNA ESRD
NE00519OtherBCBS ESRD
NE=========007OtherTRICARE ESRD
NE=========02Medicaid
NE282304Medicare Oscar/Certification