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General NPI Number Information
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NPI Number | 1932885381
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Entity Type | Organization
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Legal Business Name | MEDELITE URGENT CARE L.L.C.
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Dates
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Enumeration Date | 06/22/2023
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 7100 S 69TH ST STE 101
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City | LINCOLN
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State | NE
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Zip | 68516-4283
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Country | US
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Telephone | 402-489-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 15877 S 64TH ST
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City | ROCA
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State | NE
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Zip | 68430-4355
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Country | US
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Telephone | 402-340-2505
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JEREMY ALAN JOHNSON
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Credential |
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Telephone | 402-340-2505
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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