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General NPI Number Information
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NPI Number | 1003119108
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Entity Type | Organization
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Legal Business Name | BEACOM FAMILY HEALTH CONNECTION, LLC
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Dates
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Enumeration Date | 12/10/2010
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 1625 E MILITARY AVE
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City | FREMONT
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State | NE
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Zip | 68025-5463
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Country | US
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Telephone | 402-721-8830
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Fax | 402-721-8840
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Provider Business Mailing Address
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Address Line | 1625 E MILITARY AVE
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City | FREMONT
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State | NE
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Zip | 68025-5463
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Country | US
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Telephone | 402-721-8830
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Fax | 402-721-8840
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSAN SCHLECHT
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Credential |
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Telephone | 402-721-8830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 21469
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License Number State | NE
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