Provider Demographics
NPI:1316299779
Name:SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SOUTH HEARTLAND DISTRICT HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:M
Authorized Official - Last Name:BEVER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:402-462-6211
Mailing Address - Street 1:606 N MINNESOTA AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:HASTINGS
Mailing Address - State:NE
Mailing Address - Zip Code:68901-5256
Mailing Address - Country:US
Mailing Address - Phone:402-462-6211
Mailing Address - Fax:402-462-6219
Practice Address - Street 1:606 N MINNESOTA AVE STE 2
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:NE
Practice Address - Zip Code:68901-5256
Practice Address - Country:US
Practice Address - Phone:402-462-6211
Practice Address - Fax:402-462-6219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-10
Last Update Date:2012-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty