St Edward Medical Clinic | |
1102 Water St St Edward NE 68660-0167 | |
(402) 678-2232 | |
(402) 678-2234 |
Full Name | St Edward Medical Clinic |
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Speciality | Clinic/Center |
Location | 1102 Water St, St Edward, Nebraska |
Authorized Official Name and Position | Joyce A Troyer (CORPORATION SECRETARY) |
Authorized Official Contact | 4026782232 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St Edward Medical Clinic Po Box F St Edward NE 68660-0167 Ph: (402) 678-2232 | St Edward Medical Clinic 1102 Water St St Edward NE 68660-0167 Ph: (402) 678-2232 |
NPI Number | 1225063266 |
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Provider Enumeration Date | 07/11/2006 |
Last Update Date | 09/26/2022 |
Medicare PECOS PAC ID | 3870575806 |
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Medicare Enrollment ID | O20040603000825 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225063266 | NPI | - | NPPES |
10025570200 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | 28D0455470 (Nebraska) | Primary |
Provider Name | Terry L Troyer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326031212 PECOS PAC ID: 2365418787 Enrollment ID: I20040908000268 |
Provider Name | Joyce Troyer |
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Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1306839295 PECOS PAC ID: 2163426792 Enrollment ID: I20100121000166 |