Organization
CITY OF GENOA
Active
Organization
CITY OF GENOA
Active
Parent organization
CITY OF GENOA
Other names
Park Street Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF GENOA
Authorized official
AMANDA ROEBUCK (CEO)
(402) 993-4583
Entity
Organization
Contact information
Practice address
505 S PARK ST, GENOA, NE 68640-3036
(402) 993-2205
(402) 993-2595
Mailing address
PO BOX 425, GENOA, NE 68640-0425
(402) 993-2206
(402) 993-2595
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/23/2017
Last updated
01/23/2020
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