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COUNTRY CLINICS PC NPI 1225063266


NPI Information

NPI: 1225063266
Provider Name: COUNTRY CLINICS PC

Doing Business As: ST EDWARD MEDICAL CLINIC

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 28D0455470

Address:
1102 WATER ST
ST EDWARD, NE
ZIP 68660
Phone: (402) 678-2232
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COUNTRY CLINICS PC is a clinic center in St Edward, NE. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). COUNTRY CLINICS PC NPI is 1225063266. The provider is registered as an organization entity type.
The provider Is Doing Business As St Edward Medical Clinic.

The provider's business location address is:

1102 WATER ST
ST EDWARD, NE
ZIP 68660-167
Phone: (402) 678-2232
Fax: (402) 678-2234

The provider's authorized official is Joyce A Troyer .
The authorized official title is Corporation Secretary and has the following contact phone number (402) 678-2232.

The CLIA number assigned to this NPI record is 28D0455470 - rural health clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 7/11/2006 and was last updated on 9/26/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center28D0455470NEBRASKAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110025570200MEDICAIDNEBRASKA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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