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General NPI Number Information
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NPI Number | 1700055704
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Entity Type | Organization
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Legal Business Name | BELLEVUE HEALTH AND EMERGENCY CLINIC, INC.
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Dates
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Enumeration Date | 02/22/2008
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Last Update Date | 10/21/2015
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Provider Practice Location Address
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Address Line | 1002 W MISSION AVE
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City | BELLEVUE
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State | NE
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Zip | 68005-3947
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Country | US
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Telephone | 402-292-4164
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Fax | 402-291-4643
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Provider Business Mailing Address
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Address Line | 1002 W MISSION AVE
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City | BELLEVUE
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State | NE
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Zip | 68005-3947
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Country | US
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Telephone | 402-292-4164
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Fax | 402-291-4643
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | MS. MARY LOU CLARK CARHART
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Credential |
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Telephone | 402-292-4164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 15162
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 15162
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 15162
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License Number State | NE
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