Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 503 N 6th St, Pierce, Nebraska |
Authorized Official Name and Position | Douglas Ekeren (CEO/PRESIDENT) |
Authorized Official Contact | 6056688321 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-4933 | 503 N 6th St Pierce NE 68767-1019 Ph: (402) 329-6780 |
NPI Number | 1336408913 |
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Provider Enumeration Date | 05/16/2012 |
Last Update Date | 04/24/2023 |
Medicare PECOS PAC ID | 6103729066 |
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Medicare Enrollment ID | O20160822002463 |
Identifier | Type | State | Issuer |
---|---|---|---|
1336408913 | NPI | - | NPPES |
NA1399 | Other | NE | MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |