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General NPI Number Information
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NPI Number | 1831446442
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Entity Type | Organization
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Legal Business Name | BROOKS CO
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 2840 S 70TH ST STE 7-368
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City | LINCOLN
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State | NE
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Zip | 68506-3662
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Country | US
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Telephone | 402-209-2008
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Fax |
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Provider Business Mailing Address
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Address Line | 2840 S 70TH ST STE 7-368
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City | LINCOLN
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State | NE
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Zip | 68506-3662
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Country | US
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Telephone | 402-209-2008
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALLAN TROLLEY
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Credential |
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Telephone | 402-209-2008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 15462
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License Number State | NE
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