Healthcare Provider Details

I. General information

NPI: 1962955187
Provider Name (Legal Business Name): 9 LINE MEDICAL SOLUTIONS,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2016
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3416 VINTON ST
OMAHA NE
68105-3936
US

IV. Provider business mailing address

PO BOX 29106
LINCOLN NE
68529-0106
US

V. Phone/Fax

Practice location:
  • Phone: 866-205-8330
  • Fax: 866-205-8332
Mailing address:
  • Phone: 866-205-8330
  • Fax: 866-205-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number12345
License Number StateKS

VIII. Authorized Official

Name: SUSAN D SMITH
Title or Position: AGENCY DIRECTOR
Credential:
Phone: 866-205-8330