Healthcare Provider Details

I. General information

NPI: 1639848633
Provider Name (Legal Business Name): OMAHA TRIBE OF NEBRASKA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2021
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MAIN STREET
WALTHILL NE
68067-0001
US

IV. Provider business mailing address

PO BOX 250
MACY NE
68039-0250
US

V. Phone/Fax

Practice location:
  • Phone: 402-837-5381
  • Fax: 402-837-5303
Mailing address:
  • Phone: 402-837-5381
  • Fax: 402-837-5303

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QE0700X
TaxonomyEnd-Stage Renal Disease (ESRD) Treatment Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code341600000X
TaxonomyAmbulance
License Number
License Number State

VIII. Authorized Official

Name: SARAH ROWLAND
Title or Position: CEO
Credential:
Phone: 402-837-5381