Healthcare Provider Details
I. General information
NPI: 1306731609
Provider Name (Legal Business Name): MEDICINE IN MOTION SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/09/2025
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4908 CASS ST
OMAHA NE
68132-2913
US
IV. Provider business mailing address
4908 CASS ST
OMAHA NE
68132-2913
US
V. Phone/Fax
- Phone: 531-375-5398
- Fax: 402-502-6823
- Phone: 531-375-5398
- Fax: 402-502-6823
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207QG0300X |
| Taxonomy | Geriatric Medicine (Family Medicine) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
REBECCA
WESTER
Title or Position: OWNER
Credential:
Phone: 531-375-5398