| |
514 9th Street Gothenburg NE 69138-1917 | |
(308) 537-2222 | |
(308) 537-2960 |
Full Name | |
---|---|
Speciality | Family Medicine |
Location | 514 9th Street, Gothenburg, Nebraska |
Authorized Official Name and Position | Christopher P Costa (OWNER) |
Authorized Official Contact | 3085372222 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
514 9th Street Gothenburg NE 69138-1917 Ph: (308) 537-2222 | 514 9th Street Gothenburg NE 69138-1917 Ph: (308) 537-2222 |
NPI Number | 1194803353 |
---|---|
Provider Enumeration Date | 11/02/2006 |
Last Update Date | 10/16/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1194803353 | NPI | - | NPPES |
10025207300 | Other | NE | RURAL HEALTH MEDICAID |
283850 | Other | RIVERBEND | |
10025207400 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 20028 (Nebraska) | Primary |
David Hult, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 918 20th Street, Gothenburg, NE 69138 Phone: 308-537-7131 Fax: 308-537-7310 | |
Carol Shackleton, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 918 20th Street, Gothenburg, NE 69138 Phone: 308-537-7131 Fax: 308-537-7310 | |
Gothenburg Family Practice Rural Health Clinic Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 918 20th Street, Gothenburg, NE 69138 Phone: 308-537-7131 Fax: 308-537-7310 |