Healthcare Provider Details
I. General information
NPI: 1942333125
Provider Name (Legal Business Name): PEDIATRIC ANESTHESIA DEPARTMENT
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
CHILDREN'S HOSPITAL 8200 DODGE STREET
OMAHA NE
68114-4113
US
IV. Provider business mailing address
PEDIATRIC ANESTHESIA DEPARTMENT PO BOX 30015
OMAHA NE
68103-1115
US
V. Phone/Fax
- Phone: 402-955-6928
- Fax: 402-955-6900
- Phone: 402-955-6928
- Fax: 402-955-6900
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NANCY
BARNA
Title or Position: DIRECTOR - REIMB & MANAGED CARE
Credential: MPA, MS, FHFMA
Phone: 402-955-6775