Healthcare Provider Details

I. General information

NPI: 1952596389
Provider Name (Legal Business Name): RAMIC OMAHA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 REGENCY PARKWAY SUITE 125
OMAHA NE
68114-3725
US

IV. Provider business mailing address

PO BOX 7268
LOVELAND CO
80537-0268
US

V. Phone/Fax

Practice location:
  • Phone: 402-391-1600
  • Fax: 402-391-0700
Mailing address:
  • Phone: 970-663-2742
  • Fax: 970-667-0847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL D RAASCH
Title or Position: OWNER
Credential:
Phone: 402-391-1600