Healthcare Provider Details

I. General information

NPI: 1730888975
Provider Name (Legal Business Name): COUNTY OF SALINE DISTRICT #82
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2023
Last Update Date: 11/06/2024
Certification Date: 11/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S FRANKLIN ST
WILBER NE
68465-4000
US

IV. Provider business mailing address

PO BOX 487
WILBER NE
68465-0487
US

V. Phone/Fax

Practice location:
  • Phone: 402-821-2266
  • Fax: 402-821-3013
Mailing address:
  • Phone: 402-821-2266
  • Fax: 402-821-3013

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier10026733200
Identifier TypeMEDICAID
Identifier StateNE
Identifier Issuer

VIII. Authorized Official

Name: MRS. ELIZABETH ROSE OURECKY
Title or Position: BOOKKEEPER
Credential:
Phone: 402-821-2266