Organization · Type 2 NPI

Thayer County Memorial Hospital

Rural Health Clinic/Center · Davenport, NE

NPI number 1972589349 Active

Practice location

105 S Linden Ave
Davenport, NE 68335-3129

Call (402) 364-2105 Map

Fax (402) 768-4640

Mailing address

120 Park Ave
Hebron, NE 68370-2019

Specialties and licenses

Taxonomy	Code	License
Rural Health Clinic/Center Primary	261QR1300X	None listed

Rural Health Clinic/Center: Definition to come...

NPI record

NPI: 1972589349
Entity type: Organization (Type 2)
Issued: Dec 19, 2005
Last updated: Dec 17, 2021
Status: Active
Subpart: Yes of Thayer County Memorial Hospital

Other names

<unavail>
Davenport Medical Clinic · doing business as
Davenport Medical Clinic · doing business as

Authorized official

Brian Rokusek
CEO
(402) 768-6041

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1972589349

Thayer County Memorial Hospital's National Provider Identifier is 1972589349, issued on Dec 19, 2005. The primary taxonomy on file is Rural Health Clinic/Center (261QR1300X), and the practice location is in Davenport, NE. The record was last updated on Dec 17, 2021.