Healthcare Provider Details

I. General information

NPI: 1154320612
Provider Name (Legal Business Name): NEWSTYLE MEDICAL SUPPLIER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 W 5TH ST
LOUISVILLE NE
68037-6007
US

IV. Provider business mailing address

411 W 5TH ST
LOUISVILLE NE
68037-6007
US

V. Phone/Fax

Practice location:
  • Phone: 402-234-2545
  • Fax: 402-234-3278
Mailing address:
  • Phone: 402-234-2545
  • Fax: 402-234-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number10024980400
License Number StateNE

VIII. Authorized Official

Name: MRS. SARAH CLINE
Title or Position: MANAGER
Credential:
Phone: 402-234-2545