Full Name | |
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Speciality | Clinic/Center |
Location | 615 4th St, Deshler, Nebraska |
Authorized Official Name and Position | Brian Rokusek (CEO) |
Authorized Official Contact | 4027686041 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
120 Park Ave Hebron NE 68370-2019 Ph: (402) 768-6041 | 615 4th St Deshler NE 68340-1811 Ph: (402) 365-7604 |
NPI Number | 1659357507 |
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Provider Enumeration Date | 12/21/2005 |
Last Update Date | 12/17/2021 |
Medicare PECOS PAC ID | 3577559145 |
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Medicare Enrollment ID | O20050222000504 |
Identifier | Type | State | Issuer |
---|---|---|---|
1659357507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |