Healthcare Provider Details

I. General information

NPI: 1447383948
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF THE MIDLANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12565 W CENTER RD SUITE 100
OMAHA NE
68144-3810
US

IV. Provider business mailing address

12565 W CENTER RD SUITE 100
OMAHA NE
68144-3802
US

V. Phone/Fax

Practice location:
  • Phone: 402-930-4206
  • Fax: 402-344-6527
Mailing address:
  • Phone: 402-930-4206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number2820
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number2820
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number3100
License Number StateIA
# 4
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number2820
License Number StateNE
# 6
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number2820
License Number StateNE
# 7
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number2146
License Number StateNE

VIII. Authorized Official

Name: LAURA GROTHE
Title or Position: PHARMACY DIRECTOR
Credential: PHARMD
Phone: 402-930-4206