MEDICARE: SALAMATA SAWADOGO

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	253Z00000X	In Home Supportive Care Agency
2	3747A0650X	Attendant Care Provider
3	3747P1801X	Personal Care Attendant
4	376J00000X	Homemaker
5	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1265395164
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SALAMATA SAWADOGO

Provider Business Mailing Address
First Line	:	11330 Q ST STE 230
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3679
Country	:	US
Telephone Number	:	402-312-7271
Fax Number	:

Provider Business Practice Location Address
First Line	:	11330 Q ST STE 230
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68137-3679
Country	:	US
Telephone Number	:	402-312-7271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ SALAMATA SAWADOGO ” Practice Location

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