Healthcare Provider Details

I. General information

NPI: 1003409871
Provider Name (Legal Business Name): SANCHEZ FAMILY MEDICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 05/10/2021
Certification Date: 05/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3440 S 50TH ST
OMAHA NE
68106-3829
US

IV. Provider business mailing address

3440 S 50TH ST
OMAHA NE
68106-3829
US

V. Phone/Fax

Practice location:
  • Phone: 402-214-9040
  • Fax: 402-884-0088
Mailing address:
  • Phone: 402-216-6020
  • Fax: 402-884-0088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. RODOLFO M. SANCHEZ
Title or Position: MD AND OWNER
Credential: MD AND OWNER
Phone: 402-216-6020