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General NPI Number Information
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NPI Number | 1083205512
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Entity Type | Organization
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Legal Business Name | BRYAN PHYSICIAN NETWORK
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Dates
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Enumeration Date | 01/28/2021
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 5055 A ST STE 400
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City | LINCOLN
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State | NE
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Zip | 68510-4970
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Country | US
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Telephone | 402-481-4485
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 S 16TH ST STE 400A
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City | LINCOLN
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State | NE
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Zip | 68502-3785
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Country | US
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Telephone | 402-483-8590
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Fax | 402-483-8599
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH MANGIAMELI JR.
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Credential |
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Telephone | 402-481-5603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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