Provider Demographics
NPI:1528140993
Name:OSMOND GENERAL HOSPITAL INC
Entity type:Organization
Organization Name:OSMOND GENERAL HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LON
Authorized Official - Middle Name:M
Authorized Official - Last Name:KNIEVEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-748-3393
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:OSMOND
Mailing Address - State:NE
Mailing Address - Zip Code:68765-0429
Mailing Address - Country:US
Mailing Address - Phone:402-748-3393
Mailing Address - Fax:402-748-6190
Practice Address - Street 1:402 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:OSMOND
Practice Address - State:NE
Practice Address - Zip Code:68765-5726
Practice Address - Country:US
Practice Address - Phone:402-748-3393
Practice Address - Fax:402-748-6190
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OSMOND GENERAL HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-10-19
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
No207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical ServicesGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE00148OtherPROF SVCS (BCBS OF NE)
NE07085OtherPROF SVCS CRNA-BCBS OF NE
NE07085OtherPROF SVCS CRNA-BCBS OF NE
SDS100268Medicare PIN
NE00148OtherPROF SVCS (BCBS OF NE)