Healthcare Provider Details

I. General information

NPI: 1114919875
Provider Name (Legal Business Name): UROLOGY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2005
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 S 90TH ST
OMAHA NE
68114-3907
US

IV. Provider business mailing address

105 S 90TH ST
OMAHA NE
68114-3963
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-9800
  • Fax: 402-397-7591
Mailing address:
  • Phone: 402-397-9800
  • Fax: 402-397-7591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2088F0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Urology) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. REBECCA J MCCRERY
Title or Position: PRESIDENT
Credential: MD
Phone: 402-397-7989