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General NPI Number Information
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NPI Number | 1952977456
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Entity Type | Organization
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Legal Business Name | NEBRASKA REGENERATIVE HEALTHCARE LLC
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Dates
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Enumeration Date | 06/03/2021
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Last Update Date | 06/03/2021
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Provider Practice Location Address
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Address Line | 2415 E 23RD AVE S STE 200
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City | FREMONT
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State | NE
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Zip | 68025-2423
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Country | US
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Telephone | 402-721-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 2415 E 23RD AVE S STE 200
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City | FREMONT
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State | NE
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Zip | 68025-2423
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Country | US
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Telephone | 402-721-5500
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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. CHARLES W SCHOLLMEYER
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Credential | DC
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Telephone | 402-721-5500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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