Organization
FAMILY MEDICAL CENTER OF HASTINGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERRY THEISEN (ADMINISTRATOR)
(402) 462-8456
Entity
Organization
Contact information
Practice address
1021 W 14TH ST, HASTINGS, NE 68901-3046
(402) 463-2423
(402) 463-9697
Mailing address
PO BOX 968, HASTINGS, NE 68902-0968
(402) 462-8456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02842
BCBS NE
NE
01
—
CO4191
RAILROAD MEDICARE
NE
Enumeration date
08/16/2006
Last updated
01/24/2023
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