Provider Demographics
NPI:1770589764
Name:ROCK COUNTY HOSPITAL
Entity type:Organization
Organization Name:ROCK COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINIC MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RAYMOND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-684-2906
Mailing Address - Street 1:801 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:BASSETT
Mailing Address - State:NE
Mailing Address - Zip Code:68714-5062
Mailing Address - Country:US
Mailing Address - Phone:402-684-2906
Mailing Address - Fax:402-684-3822
Practice Address - Street 1:801 S STATE ST
Practice Address - Street 2:
Practice Address - City:BASSETT
Practice Address - State:NE
Practice Address - Zip Code:68714-5062
Practice Address - Country:US
Practice Address - Phone:402-684-2906
Practice Address - Fax:402-684-3822
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-23
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEBCBSOther07585
NE=========19Medicaid
NE=========10Medicaid
NEBCBSOther07585
NE=========19Medicaid