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General NPI Number Information
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NPI Number | 1275967051
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Entity Type | Organization
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Legal Business Name | ROSE SALTER MEDICAL RESEARCH FOUNDATION
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Dates
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Enumeration Date | 08/28/2013
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Last Update Date | 02/22/2016
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Provider Practice Location Address
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Address Line | 601 N. 30TH ST. SUITE 6715
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City | OMAHA
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State | NE
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Zip | 68131-2137
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Country | US
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Telephone | 402-578-1580
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Fax | 402-280-5245
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Provider Business Mailing Address
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Address Line | 660 S 85TH ST
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City | OMAHA
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State | NE
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Zip | 68114-4206
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Country | US
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Telephone | 402-578-1580
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Fax | 402-280-5245
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARC STEPHEN RENDELL
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Credential | MD
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Telephone | 402-578-1580
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 17167
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License Number State | NE
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