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General NPI Number Information
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NPI Number | 1336125202
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Entity Type | Organization
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Legal Business Name | NEBRASKA HEART INSTITUTE PC
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Dates
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Enumeration Date | 12/21/2005
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Last Update Date | 08/11/2008
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Provider Practice Location Address
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Address Line | 7440 SOUTH 91ST STREET
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City | LINCOLN
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State | NE
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Zip | 68526-9797
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Country | US
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Telephone | 402-489-6555
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Fax | 402-328-3989
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Provider Business Mailing Address
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Address Line | PO BOX 82585
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City | LINCOLN
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State | NE
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Zip | 68501-2585
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Country | US
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Telephone | 402-489-6555
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Fax | 402-328-3989
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Authorized Official
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Title or Position | CONTROLLER
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Name | MR. MARLIN AUSDEMORE
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Credential |
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Telephone | 402-328-3721
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0001X
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Taxonomy Name | Clinical Cardiac Electrophysiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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