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Organization

WESTERN FAMILY MEDICINE PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD C. MCCOY (SECRETARY)
(308) 630-7977
Entity
Organization

Contact information

Practice address
2 W 42ND STREET, SUITE 2800, SCOTTSBLUFF, NE 69361-4660
(308) 630-7977
(308) 630-1028
Mailing address
PO BOX 1498, SCOTTSBLUFF, NE 69363-1498
(308) 630-7977
(308) 630-1028

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
NE

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10026385500
NE
Enumeration date
07/19/2005
Last updated
11/18/2014
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