Provider Demographics
NPI:1588972459
Name:MERRICK COUNTY
Entity type:Organization
Organization Name:MERRICK COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-946-3015
Mailing Address - Street 1:1715 26TH STREET
Mailing Address - Street 2:
Mailing Address - City:CENTRAL CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68826-9501
Mailing Address - Country:US
Mailing Address - Phone:308-946-3015
Mailing Address - Fax:308-946-5914
Practice Address - Street 1:1715 26TH ST
Practice Address - Street 2:
Practice Address - City:CENTRAL CITY
Practice Address - State:NE
Practice Address - Zip Code:68826-9501
Practice Address - Country:US
Practice Address - Phone:308-946-3015
Practice Address - Fax:308-946-5914
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MERRICK COUNTY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-09-14
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health