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General NPI Number Information
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NPI Number | 1154943835
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Entity Type | Organization
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Legal Business Name | VWB LLC
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Dates
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Enumeration Date | 05/15/2020
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Last Update Date | 05/15/2020
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Provider Practice Location Address
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Address Line | 4004 N 132ND ST STE 101
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City | OMAHA
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State | NE
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Zip | 68164-1803
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Country | US
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Telephone | 402-302-2273
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Fax | 402-513-8700
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Provider Business Mailing Address
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Address Line | PO BOX 5943
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City | VIRGINIA BEACH
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State | VA
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Zip | 23471-0943
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NATHAN VAN WINKLE
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Credential | NP
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Telephone | 402-302-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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