Provider Demographics
NPI:1588771158
Name:COMMUNITY HOSPITAL ASSOCIATION
Entity type:Organization
Organization Name:COMMUNITY HOSPITAL ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BRUNTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-344-8315
Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:MCCOOK
Mailing Address - State:NE
Mailing Address - Zip Code:69001-1328
Mailing Address - Country:US
Mailing Address - Phone:308-344-2650
Mailing Address - Fax:308-344-8358
Practice Address - Street 1:1301 E H ST
Practice Address - Street 2:
Practice Address - City:MC COOK
Practice Address - State:NE
Practice Address - Zip Code:69001-3482
Practice Address - Country:US
Practice Address - Phone:308-344-2650
Practice Address - Fax:308-344-8358
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE COMMUNITY HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-08-23
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE03615OtherBLUE CROSS RHC
NE81042OtherBLUE CROSS DIABETIC
NE03424OtherBLUE CROSS
NE03615OtherBLUE CROSS RHC
NE81042OtherBLUE CROSS DIABETIC
NE=========12Medicaid
NE=========13Medicaid
NE=========14Medicaid
NE=========21Medicaid