Organization
MERRICK MEDICAL CENTER
Active
Parent organization
MERRICK MEDICAL CENTER
Other names
FULLERTON MEDICAL CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MERRICK MEDICAL CENTER
Authorized official
JODI S MOHR (CEO)
(402) 946-3015
Entity
Organization
Contact information
Practice address
901 BROADWAY ST, FULLERTON, NE 68638-3151
(308) 536-2458
Mailing address
PO BOX 860874, MINNEAPOLIS, MN 55486-0874
(308) 946-3015
(308) 946-5914
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
03/23/2017
Last updated
07/24/2024
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