Provider Demographics
NPI:1124127121
Name:CHERRY COUNTY HOSPITAL
Entity type:Organization
Organization Name:CHERRY COUNTY HOSPITAL
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-376-2525
Mailing Address - Street 1:510 N GREEN ST
Mailing Address - Street 2:
Mailing Address - City:VALENTINE
Mailing Address - State:NE
Mailing Address - Zip Code:69201-1932
Mailing Address - Country:US
Mailing Address - Phone:402-376-2525
Mailing Address - Fax:402-376-1627
Practice Address - Street 1:510 N GREEN ST
Practice Address - Street 2:
Practice Address - City:VALENTINE
Practice Address - State:NE
Practice Address - Zip Code:69201-1932
Practice Address - Country:US
Practice Address - Phone:402-376-2525
Practice Address - Fax:402-376-1627
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHERRY COUNTY HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-22
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE140001261QE0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00064OtherBCBS OF NEBRASKA
NE10025033200Medicaid
NE282315Medicare Oscar/Certification