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General NPI Number Information
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NPI Number | 1265975460
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Entity Type | Organization
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Legal Business Name | COMPER CARE OUTPATIENT CENTER INC
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Dates
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Enumeration Date | 11/21/2016
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Last Update Date | 11/21/2016
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Provider Practice Location Address
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Address Line | 205 S 23RD ST SUITE 1
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-2900
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Country | US
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Telephone | 402-298-4555
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Fax | 402-298-4123
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Provider Business Mailing Address
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Address Line | 205 S 23RD ST SUITE 1
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-2900
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Country | US
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Telephone | 402-298-4555
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Fax | 402-298-4123
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | JENNIFER GLUP
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Credential |
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Telephone | 402-298-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number |
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License Number State | NE
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