Healthcare Provider Details

I. General information

NPI: 1528865664
Provider Name (Legal Business Name): JOSHUA BUSQUE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TOBIAS BUSQUE

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1905 HARNEY ST STE 703
OMAHA NE
68102-2366
US

IV. Provider business mailing address

14227 KARL ST
OMAHA NE
68137-1507
US

V. Phone/Fax

Practice location:
  • Phone: 402-346-6164
  • Fax: 402-346-6928
Mailing address:
  • Phone: 402-346-6164
  • Fax: 402-346-6928

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: