Organization
BRODSTONE MEMORIAL HOSPITAL
Active
Organization
BRODSTONE MEMORIAL HOSPITAL
Active
Parent organization
BRODSTONE MEMORIAL HOSPITAL
Other names
BRODSTONE FAMILY MEDICAL CENTER - SUPERIOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRODSTONE MEMORIAL HOSPITAL
Authorized official
TREG VYZOUREK (CEO)
(402) 879-3281
Entity
Organization
Contact information
Practice address
525 E 11TH ST, SUPERIOR, NE 68978-1101
(402) 879-4781
(402) 879-3365
Mailing address
PO BOX 407, SUPERIOR, NE 68978-0407
(402) 879-4781
(402) 879-3365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
2084A2900X
Neurocritical Care Physician
—
—
2084N0400X
Neurology Physician
—
—
2084V0102X
Vascular Neurology Physician
—
—
208M00000X
Hospitalist Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025177900
—
NE
Enumeration date
12/26/2005
Last updated
02/12/2025
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