Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 119 South 4th, Indianola, Nebraska |
Authorized Official Name and Position | Deborah Herzberg (CEO) |
Authorized Official Contact | 3086973329 |
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 488 Cambridge NE 69022 Ph: (308) 697-1526 | 119 South 4th Indianola NE 69034 Ph: (308) 697-1419 |
NPI Number | 1316034846 |
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Provider Enumeration Date | 10/06/2006 |
Last Update Date | 03/02/2015 |
Medicare PECOS PAC ID | 2466346077 |
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Medicare Enrollment ID | O20061115000340 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316034846 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (Nebraska) | Primary |