Full Name | |
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Speciality | Clinic/Center |
Location | 219 Main St, Bancroft, Nebraska |
Authorized Official Name and Position | Laura J Gamble (CEO) |
Authorized Official Contact | 4023853083 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 100 Pender NE 68047-0100 Ph: (402) 385-4012 | 219 Main St Bancroft NE 68004-3021 Ph: (402) 648-7606 |
NPI Number | 1376971036 |
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Provider Enumeration Date | 10/16/2013 |
Last Update Date | 10/17/2022 |
Medicare PECOS PAC ID | 3971412842 |
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Medicare Enrollment ID | O20140205000305 |
Identifier | Type | State | Issuer |
---|---|---|---|
1376971036 | NPI | - | NPPES |