COLGLAZIER CLINIC (NPI# 1366543365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366543365 |
| Entity Type | Organization |
| Organization Name | COLGLAZIER CLINIC |
| Practice Address |
945 Washington Avenue Grant NE 69140-0097 |
| Mailing Address |
945 Washington Avenue Po Box 97 Grant NE 69140-0097 |
| Practice Telephone | 3083522122 |
| Practice Fax Number | 3083522281 |
| Mailing Telephone | 3083522122 |
| Mailing Fax Number | 3083522281 |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2008-05-28 |
| Authorized Official Name | DR. CLIFFORD R. COLGLAZIER (OWNER) |
| Authorized Official Telephone | 3083522122 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
14390 | NE | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | BLUE CROSS | 2717 | 01 |
| Street Address |
945 WASHINGTON AVENUE |
| City | GRANT |
| State | NE |
| Zip Code | 69140-0097 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649248220 | John Matthew Byrd | Family Medicine | 912 Central Avenue, Grant, NE 69140 | 2006-03-09 |
| 1508969189 | Marvin Allen Swan | Dentist | 242 Central Ave, Grant, NE 69140-0863 | 2006-09-07 |
| 1528255668 | First Insight Eyecare, LLC | Optometrist | 115 W 3rd, Grant, NE 69140-0950 | 2007-10-03 |
| 1255340717 | Jorje Jette Geisert | Pharmacist | 218 Central Ave, Grant, NE 69140-3016 | 2006-08-05 |
| 1740526151 | J&j Pharms. LLC | Pharmacy | 218 Central Ave, Grant, NE 69140-3016 | 2012-12-13 |
| 1073648663 | J & J Pharmacies LLC | Pharmacy | 218 Central Ave, Grant, NE 69140-3016 | 2007-02-22 |
| 1619912045 | County of Perkins | Ambulance | 342 Central Ave, Grant, NE 69140-3021 | 2006-06-19 |
| 1285631721 | Clifford Ray Colglazier | General Practice | 945 Washington Ave, Grant, NE 69140-3044 | 2005-06-30 |
| 1235683087 | Julie Kuskie | Nurse Practitioner | 945 Washington Ave, Grant, NE 69140-3044 | 2016-08-10 |
| 1770580227 | Ruth Demmel | Family Medicine | 945 Washington Ave, Grant, NE 69140-3044 | 2005-06-30 |
| Find all providers in zip 69140 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.