Healthcare Provider Details

I. General information

NPI: 1033359732
Provider Name (Legal Business Name): CHILDREN'S HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2009
Last Update Date: 03/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 NORTH 175 STREET, SUITE 1000 CHILDREN'S HOSPITAL - URGENT CARE - WEST VILLAGE POINTE
OMAHA NE
68118
US

IV. Provider business mailing address

8200 DODGE STREET CHILDREN'S HOSPITAL
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-8300
  • Fax:
Mailing address:
  • Phone: 402-955-5400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: NANCY BARNA
Title or Position: INTERNAL AUDIT MANAGER
Credential: MPA, MS, FHFMA, CPC
Phone: 402-955-6775