Healthcare Provider Details

I. General information

NPI: 1255224747
Provider Name (Legal Business Name): UROLOGY CENTER PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2025
Last Update Date: 06/29/2025
Certification Date: 06/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10707 PACIFIC ST STE 101
OMAHA NE
68114-4762
US

IV. Provider business mailing address

105 S 90TH ST
OMAHA NE
68114-3963
US

V. Phone/Fax

Practice location:
  • Phone: 402-397-7989
  • Fax: 402-397-8703
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