Provider Demographics
NPI:1548362809
Name:COLUMBUS COMMUNITY HOSPITAL INC
Entity type:Organization
Organization Name:COLUMBUS COMMUNITY HOSPITAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:E
Authorized Official - Last Name:VAN CLEAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-564-7118
Mailing Address - Street 1:PO BOX 1800
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NE
Mailing Address - Zip Code:68602-1800
Mailing Address - Country:US
Mailing Address - Phone:402-564-7118
Mailing Address - Fax:402-562-3378
Practice Address - Street 1:303 MAIN ST
Practice Address - Street 2:
Practice Address - City:HUMPHREY
Practice Address - State:NE
Practice Address - Zip Code:68642-3155
Practice Address - Country:US
Practice Address - Phone:402-923-0412
Practice Address - Fax:402-923-0414
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COLUMBUS COMMUNITY HOSPITAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-09-05
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE=========08Medicaid
NE098933Medicare PIN
NE288519Medicare Oscar/Certification
NECJ8821Medicare PIN