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NPI 1689112690

NPI 1689112690 : ME URGENT CARE NEBRASKA, INC : LINCOLN, NE

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General NPI Number Information
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    NPI Number           |    1689112690
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    Entity Type          |    Organization 
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    Legal Business Name  |    ME URGENT CARE NEBRASKA, INC 
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Dates
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    Enumeration Date     |    02/09/2017
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    Last Update Date     |    04/07/2017
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Provider Practice Location Address
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    Address Line         |    110 N 66TH ST 
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    City                 |    LINCOLN
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    State                |    NE
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    Zip                  |    68505-2402
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    Country              |    US
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    Telephone            |    402-325-8950
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    Fax                  |    402-325-8570
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Provider Business Mailing Address
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    Address Line         |    1001 CONSOL ENERGY DR 
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    City                 |    CANONSBURG
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    State                |    PA
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    Zip                  |    15317-6506
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    Country              |    US
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    Telephone            |    304-225-2500
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    Fax                  |    724-743-1133
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Authorized Official
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    Title or Position    |    DIRECTOR PAYOR CONTRACTING
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    Name                 |    MR. BRETT  GALL 
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    Credential           |    
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    Telephone            |    304-225-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine 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        |    261QU0200X
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    Taxonomy Name        |    Urgent Care Clinic/Center
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    License Number       |    
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    License Number State |    
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