Healthcare Provider Details

I. General information

NPI: 1710277033
Provider Name (Legal Business Name): AMERICAN ACCESS CARE OF OMAHA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 04/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 N 90TH ST
OMAHA NE
68114-2702
US

IV. Provider business mailing address

182 INDUSTRIAL RD
GLEN ROCK PA
17327-8626
US

V. Phone/Fax

Practice location:
  • Phone: 402-998-5029
  • Fax: 402-998-5032
Mailing address:
  • Phone: 717-235-9352
  • Fax: 717-235-4024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAYMOND FIGUEROA
Title or Position: CEO
Credential:
Phone: 717-235-0181