Organization
BRODSTONE MEMORIAL HOSPITAL
Active
Parent organization
BRODSTONE MEMORIAL HOSPITAL
Other names
BRODSTONE FAMILY MEDICAL CENTER - EDGAR, EDGAR MEDICAL CLINIC
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
315 N C ST, EDGAR, NE 68935-3194
(402) 224-3344
(402) 224-3346
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
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025288500
—
NE
05
—
10025359800
—
NE
Enumeration date
01/31/2006
Last updated
03/23/2022
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