Full Name | |
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Speciality | Clinic/Center |
Location | 108 N 1st St, Newman Grove, Nebraska |
Authorized Official Name and Position | Caleb K Poore (CEO) |
Authorized Official Contact | 4023953213 |
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 151 Albion NE 68620-0151 Ph: (402) 395-2191 | 108 N 1st St Newman Grove NE 68758 Ph: (402) 447-6214 |
NPI Number | 1750778940 |
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Provider Enumeration Date | 04/25/2015 |
Last Update Date | 04/18/2024 |
Medicare PECOS PAC ID | 1254306178 |
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Medicare Enrollment ID | O20160412001688 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750778940 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |