MEDICARE: SOTO'S INTERNATIONAL ENTERPRISES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332BC3200X	Customized Equipment (DME)		NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144276676
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOTO'S INTERNATIONAL ENTERPRISES INC

Provider Business Mailing Address
First Line	:	3140 O ST
Second Line	:	STE 100
City	:	LINCOLN
State	:	NE
Zip	:	68510-1537
Country	:	US
Telephone Number	:	402-476-5222
Fax Number	:	402-476-5250

Provider Business Practice Location Address
First Line	:	3140 O ST
Second Line	:	STE 100
City	:	LINCOLN
State	:	NE
Zip	:	68510-1537
Country	:	US
Telephone Number	:	402-476-5222
Fax Number	:	402-476-5250

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MR. JIMMY SOTO
Credential	:
Telephone Number	:	402-476-5222

Provider Enumeration Date	:	05/26/2006
Last Update Date	:	07/21/2022

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