Healthcare Provider Details

I. General information

NPI: 1871966184
Provider Name (Legal Business Name): OSIE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 N COTNER BLVD STE 1
LINCOLN NE
68505-1879
US

IV. Provider business mailing address

1221 N COTNER BLVD STE 1
LINCOLN NE
68505-1879
US

V. Phone/Fax

Practice location:
  • Phone: 402-466-7283
  • Fax: 402-466-5387
Mailing address:
  • Phone: 402-466-7283
  • Fax: 402-466-5387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2590
License Number StateNE

VIII. Authorized Official

Name: STEVAN OSENBAUGH
Title or Position: PRESIDENT
Credential:
Phone: 402-466-7283