Healthcare Provider Details

I. General information

NPI: 1003417866
Provider Name (Legal Business Name): NEBRASKA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2020
Last Update Date: 11/06/2020
Certification Date: 10/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 EMILE ST
OMAHA NE
68198-0600
US

IV. Provider business mailing address

987400 NEBRASKA MEDICAL CTR
OMAHA NE
68198-7400
US

V. Phone/Fax

Practice location:
  • Phone: 402-552-2000
  • Fax:
Mailing address:
  • Phone: 402-552-2040
  • Fax: 402-552-2512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: STEPHANIE DAUBERT
Title or Position: CFO
Credential:
Phone: 402-552-2889