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General NPI Number Information
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NPI Number | 1184272577
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Entity Type | Organization
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Legal Business Name | NEBRASKA KIDNEY HEALTH PC
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Dates
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Enumeration Date | 08/28/2019
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Last Update Date | 08/28/2019
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Provider Practice Location Address
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Address Line | 1900 N SAINT JOSEPH AVE
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City | HASTINGS
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State | NE
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Zip | 68901-2652
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Country | US
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Telephone | 402-463-4893
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Fax | 402-463-7049
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Provider Business Mailing Address
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Address Line | 3601 LAKE PARK LN
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City | HASTINGS
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State | NE
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Zip | 68901-2581
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Country | US
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Telephone | 402-984-9696
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAMEZ HABASH
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Credential |
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Telephone | 402-984-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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