Jennie M Melham Memorial Medical Center
Organization Active NPI Community Based Hospice Care Agency · Broken Bow, NE
NPI 1245305655 · NPPES record last updated Jan 10, 2020
Key facts
- NPI
- 1245305655
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community Based Hospice Care Agency 251G00000X
- Legal business name
- JENNIE M MELHAM MEMORIAL MEDICAL CENTER
- Practice address
- 145 Memorial Dr
Broken Bow, NE 68822-1378 - Phone
- (308) 872-2625
- Fax
- (308) 872-6116
- NPI assigned
- Nov 21, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Timothy L Schuckman
- Title
- Vice President-Cfo
- Phone
- (308) 872-2625
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Based Hospice Care Agency | 251G00000X | Yes |
Addresses
Primary practice location
145 Memorial Dr
Broken Bow, NE 68822-1378
Mailing address
PO Box 250
Broken Bow, NE 68822-0250
Phone (308) 872-2625
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10025136500 | Medicaid | NE | |
| 00368 | Other | BLUE CROSS HOSPICE NUMBER |
Other names
- Custer County Hospice
Other providers in Broken Bow, NE
- Angie Marie Hunt
- Teddy Eugene Hunt
- Loren Henning Jacobsen
- Julie Anne Jacobson
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center
- Jennie M Melham Memorial Medical Center Inc
- Jennie M Melham Memorial Medical Center Inc
- Jennie M Melham Memorial Medical Center Inc
All providers in Broken Bow, NE · Community Based Hospice Care Agency in Nebraska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 10, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.