Healthcare Provider Details
I. General information
NPI: 1346438041
Provider Name (Legal Business Name): ALEGENT HEALTH BERGAN MERCY HEALTH SYSTEM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/09/2007
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7710 MERCY RD STE 105
OMAHA NE
68124-2372
US
IV. Provider business mailing address
5428 F ST
OMAHA NE
68117-2815
US
V. Phone/Fax
- Phone: 402-343-8500
- Fax: 402-343-8501
- Phone: 402-898-8403
- Fax: 402-898-8484
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332BX2000X |
| Taxonomy | Oxygen Equipment & Supplies (DME) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EVERT
KUIPER
Title or Position: CEO
Credential:
Phone: 402-343-4420