Healthcare Provider Details

I. General information

NPI: 1285702753
Provider Name (Legal Business Name): NEBRASKA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 BELLEVUE MEDICAL CENTER DR SUITE 100
BELLEVUE NE
68123-1520
US

IV. Provider business mailing address

987400 NEBRASKA MEDICAL CTR
OMAHA NE
68198-7400
US

V. Phone/Fax

Practice location:
  • Phone: 402-595-1156
  • Fax: 402-595-1029
Mailing address:
  • Phone: 402-552-2040
  • Fax: 402-552-2152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2874
License Number StateNE

VIII. Authorized Official

Name: MS. STEPHANIE DAUBERT
Title or Position: CFO
Credential:
Phone: 402-552-2889