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General NPI Number Information
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NPI Number | 1427872480
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Entity Type | Organization
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Legal Business Name | THIRD JOHN HEALTH CORPORATION
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 1299 FARNAM ST
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City | OMAHA
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State | NE
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Zip | 68102-1880
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Country | US
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Telephone | 800-388-4047
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Fax |
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Provider Business Mailing Address
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Address Line | 1299 FARNAM ST
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City | OMAHA
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State | NE
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Zip | 68102-1880
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Country | US
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Telephone | 800-388-4047
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EUGENE FURNACE
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Credential | NP
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Telephone | 800-388-4047
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine 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 | 2084P0800X
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Taxonomy Name | Psychiatry 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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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