Healthcare Provider Details
I. General information
NPI: 1437827029
Provider Name (Legal Business Name): CARE CLINICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/31/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1002 W MISSION AVE
BELLEVUE NE
68005-3947
US
IV. Provider business mailing address
1002 W MISSION AVE
BELLEVUE NE
68005-3947
US
V. Phone/Fax
- Phone: 402-292-4164
- Fax: 402-292-4643
- Phone: 402-292-4164
- Fax: 402-292-4643
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VG0400X |
| Taxonomy | Gynecology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LEROY
H
CARHART
JR.
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 402-292-4164