Provider Demographics
NPI:1770662512
Name:MEMORIAL HEALTH CARE SYSTEMS
Entity type:Organization
Organization Name:MEMORIAL HEALTH CARE SYSTEMS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:E
Authorized Official - Last Name:JERGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-646-4628
Mailing Address - Street 1:300 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2299
Mailing Address - Country:US
Mailing Address - Phone:402-646-4628
Mailing Address - Fax:402-646-4605
Practice Address - Street 1:300 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2299
Practice Address - Country:US
Practice Address - Phone:402-643-2971
Practice Address - Fax:402-646-4605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
NE720001282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00055OtherBCBS OF NE (HOSPITAL)
NE36891OtherDMEPOS (BCBS OF NE)
NE=========62Medicaid
NE00055OtherBCBS OF NE (HOSPITAL)
NE=========62MedicaidDMEPOS NUMBER
NE=========00MedicaidHOSPITAL
NE36891OtherDMEPOS (BCBS OF NE)
NE=========00MedicaidHOSPITAL