| Organization Name: | JENNIE M. MELHAM MEMORIAL MEDICAL CENTER |
| NPI Number: | 1245305655 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TIMOTHY L SCHUCKMAN (VICE PRESIDENT-CFO) |
| Mailing Address: | 145 Memorial Dr Broken Bow |
| State: | NE US |
| Postal Code: | 688221378 |
| Phone Number: | 3088722625 |
| Fax Number: | 3088726116 |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |