Provider Demographics
NPI:1881985646
Name:MED-CARE, INC
Entity type:Organization
Organization Name:MED-CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:J
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:308-398-1147
Mailing Address - Street 1:603 N DIERS AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803
Mailing Address - Country:US
Mailing Address - Phone:308-398-1147
Mailing Address - Fax:308-398-1149
Practice Address - Street 1:920 E 56TH
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847
Practice Address - Country:US
Practice Address - Phone:308-237-9696
Practice Address - Fax:308-237-4517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-28
Last Update Date:2011-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE21104174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE099515OtherMEDICARE PTAN
NJ01463OtherBLUE CROSS BLUE SHIELD
NE10025099800Medicaid