NPI 1073590626 · live from the CMS NPI Registry
Brodstone Memorial Hospital
Clinic/Center, Rural Health in Superior, NE. National Provider Identifier 1073590626, active.
NPI record
| NPI | 1073590626 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Rural Health 261QR1300X |
| Practice location | 525 E 11th St, Superior, NE 68978 |
| Practice phone | 402-879-4781 |
| Mailing address | Po Box 407, Superior, NE 68978 |
| Enumerated | December 26, 2005 |
| Last updated | February 12, 2025 |
| Authorized official | Treg Vyzourek, Ceo |
| Other names | Brodstone Family Medical Center - Superior |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Medicine | 207Q00000X | — |
| Internal Medicine | 207R00000X | — |
| Internal Medicine, Endocrinology, Diabetes & Metabolism | 207RE0101X | — |
| Neurological Surgery | 207T00000X | — |
| Psychiatry & Neurology, Neurocritical Care | 2084A2900X | — |
| Psychiatry & Neurology, Neurology | 2084N0400X | — |
| Psychiatry & Neurology, Vascular Neurology | 2084V0102X | — |
| Hospitalist | 208M00000X | — |
| Clinic/Center, Rural Health primary | 261QR1300X | — |
| Physician Assistant | 363A00000X | — |
| Nurse Practitioner | 363L00000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.