MEDICARE: HEARTLAND EMERGICARE

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician
2	261QE0002X	Emergency Care Clinic/Center

General Provider Information

NPI Number	:	1578647772
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND EMERGICARE

Provider Business Mailing Address
First Line	:	TOTAL HEALTHCARE
Second Line	:	14610 W CENTER RD
City	:	OMAHA
State	:	NE
Zip	:	68144
Country	:	US
Telephone Number	:	402-731-7333
Fax Number	:	402-614-5405

Provider Business Practice Location Address
First Line	:	HEARTLAND EMERGICARE
Second Line	:	2429 M STR
City	:	OMAHA
State	:	NE
Zip	:	68107
Country	:	US
Telephone Number	:	402-731-7333
Fax Number	:	402-614-5405

Authorized Official
Title or Position	:	CEO
Name	:	MR. DAVID E KERSHNER
Credential	:	PA-C
Telephone Number	:	402-330-7403

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	12/26/2009

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Directions to “HEARTLAND EMERGICARE ” Practice Location

Language	Start Address	Practice Location

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