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HERITAGE OF FAIRBURY/ST EDWARD INC NPI 1619085123


NPI Information

NPI: 1619085123
Provider Name: HERITAGE OF FAIRBURY/ST EDWARD, INC

Doing Business As: HERITAGE CARE CENTER

Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 28D0454736

Address:
909 17TH ST
FAIRBURY, NE
ZIP 68352
Phone: (402) 729-2289
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HERITAGE OF FAIRBURY/ST EDWARD, INC is a skilled nursing facility in Fairbury, NE. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. HERITAGE OF FAIRBURY/ST EDWARD, INC NPI is 1619085123. The provider is registered as an organization entity type.
The provider Is Doing Business As Heritage Care Center.

The provider's business location address is:

909 17TH ST
FAIRBURY, NE
ZIP 68352-215
Phone: (402) 729-2289
Fax: (402) 729-5233

The provider's authorized official is Jack Dean Vetter .
The authorized official title is President and has the following contact phone number (402) 895-3932.

The CLIA number assigned to this NPI record is 28D0454736 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/25/2006 and was last updated on 12/20/2010.


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
1314000000XSkilled Nursing Facility444001NEBRASKAYes

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=========00MEDICAIDNEBRASKA
228D0454736MEDICARE ID-TYPE UNSPECIFIEDNEBRASKAMEDICARE CLIA WAIVER
3285262MEDICARE OSCAR/CERTIFICATIONNEBRASKA
40581480002MEDICARE NSCNEBRASKA

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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