Provider Demographics
NPI:1053760504
Name:CENTRAL NEBRASKA MEDICAL CLINIC ARCADIA
Entity type:Organization
Organization Name:CENTRAL NEBRASKA MEDICAL CLINIC ARCADIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:SINNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-872-2486
Mailing Address - Street 1:145 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:BROKEN BOW
Mailing Address - State:NE
Mailing Address - Zip Code:68822-1378
Mailing Address - Country:US
Mailing Address - Phone:308-872-2486
Mailing Address - Fax:308-872-2027
Practice Address - Street 1:110 WEST BRIDGE STREET
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:NE
Practice Address - Zip Code:68815
Practice Address - Country:US
Practice Address - Phone:308-872-2486
Practice Address - Fax:308-872-2027
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL NEBRASKA MEDICAL CLINIC PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care