Provider Demographics
NPI:1215445994
Name:JEFFERSON COMMUNITY HEALTH CENTER INC
Entity type:Organization
Organization Name:JEFFERSON COMMUNITY HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:JURGENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-729-3351
Mailing Address - Street 1:PO BOX 277
Mailing Address - Street 2:
Mailing Address - City:FAIRBURY
Mailing Address - State:NE
Mailing Address - Zip Code:68352-0277
Mailing Address - Country:US
Mailing Address - Phone:402-729-3351
Mailing Address - Fax:402-729-6026
Practice Address - Street 1:316 N MADISON AVE
Practice Address - Street 2:STE 200
Practice Address - City:PLYMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68424-4110
Practice Address - Country:US
Practice Address - Phone:402-729-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JEFFERSON COMMUNITY HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-17
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty