Organization
JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Active
Other names
Jennie M. Melham Memorial Medical Center-LTC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY L SCHUCKMAN (VICE PRESIDENT-CFO)
(307) 872-2625
Entity
Organization
Contact information
Practice address
145 MEMORIAL DR, BROKEN BOW, NE 68822-1378
(308) 872-2625
(308) 872-6116
Mailing address
PO BOX 250, BROKEN BOW, NE 68822-0250
(308) 872-2625
(308) 872-6116
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
LTCH004
NE
Other
Enumeration date
11/22/2006
Last updated
01/10/2020
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