SACRED HEART RURAL HEALTH CLINICS NPI 1336196617

NPI Information

NPI: 1336196617
Provider Name: SACRED HEART RURAL HEALTH CLINICS

Doing Business As: AVERA MEDICAL GROUP CROFTON

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
203 W MAIN ST
CROFTON, NE
ZIP 68730
Phone: (402) 388-2343
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SACRED HEART RURAL HEALTH CLINICS is a rural health clinic center in Crofton, NE. SACRED HEART RURAL HEALTH CLINICS NPI is 1336196617. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Crofton.

The provider's business location address is:

203 W MAIN ST
CROFTON, NE
ZIP 68730-307
Phone: (402) 388-2343
Fax: (402) 388-2554

The provider's authorized official is Pamela J Rezac .
The authorized official title is President & Ceo and has the following contact phone number (605) 668-8000.

The enumeration date for this NPI number is 5/30/2006 and was last updated on 2/8/2012.

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
1	261QR1300X	Clinic/Center	Rural Health			Yes

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
1	=========22	MEDICAID	NEBRASKA
2	=========12	MEDICAID	NEBRASKA
3	283427	MEDICARE ID-TYPE UNSPECIFIED	NEBRASKA	RURAL HEALTH CLINIC #
4	098965	MEDICARE ID-TYPE UNSPECIFIED	NEBRASKA	NON-RURAL HEALTH CLINIC #

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: 4/28/2024

NPI Synchronization or Removal

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