SACRED HEART RURAL HEALTH CLINICS NPI 1801989967

NPI Information

NPI: 1801989967
Provider Name: SACRED HEART RURAL HEALTH CLINICS

Doing Business As: AVERA MEDICAL GROUP NIOBRARA

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

Specialization: Rural Health

Address:
25410 PARK AVE
APARTMENT E
NIOBRARA, NE
ZIP 68760
Phone: (402) 857-3398
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SACRED HEART RURAL HEALTH CLINICS is a rural health clinic center in Niobrara, NE. SACRED HEART RURAL HEALTH CLINICS NPI is 1801989967. The provider is registered as an organization entity type.
The provider Is Doing Business As Avera Medical Group Niobrara.

The provider's business location address is:

25410 PARK AVE
APARTMENT E
NIOBRARA, NE
ZIP 68760-044
Phone: (402) 857-3398
Fax: (402) 857-3315

The provider's authorized official is Pam Rezac .
The authorized official title is President/ceo and has the following contact phone number (605) 668-8322.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 2/7/2012.

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	0747440004	MEDICARE NSC	NEBRASKA
2	=========	OTHER	NEBRASKA	BLUE SHIELD
3	283460	MEDICARE ID-TYPE UNSPECIFIED	NEBRASKA	RURAL HEALTH MEDICARE
4	10025008100	MEDICAID	NEBRASKA
5	921087	OTHER	NEBRASKA	DAKOTACARE

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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