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General NPI Number Information
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NPI Number | 1255920443
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Entity Type | Organization
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Legal Business Name | PHYSICIANS CLINIC, INC.
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Dates
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Enumeration Date | 01/13/2021
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 1240 E 23RD ST
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City | FREMONT
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State | NE
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Zip | 68025-2411
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Country | US
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Telephone | 402-815-7100
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3755
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City | OMAHA
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State | NE
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Zip | 68103-0755
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Country | US
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Telephone | 402-354-2100
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KERI CHARRON
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Credential |
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Telephone | 402-354-5602
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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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