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NPI Code Detail

MEDICARE: PAIN MANAGEMENT PC

MEDICARE: PAIN MANAGEMENT PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist100507NE

General Provider Information

NPI Number : 1003026253
Entity Type Code : Organization
Provider Name (Legal Business Name) : PAIN MANAGEMENT PC
Provider Business Mailing Address
First Line : 13811 CHARLES ST
Second Line :
City : OMAHA
State : NE
Zip : 68154-3883
Country : US
Telephone Number : 402-492-8544
Fax Number : 402-391-8979
Provider Business Practice Location Address
First Line : 8031 W CENTER RD
Second Line : SUITE 226
City : OMAHA
State : NE
Zip : 68124-3134
Country : US
Telephone Number : 402-391-8978
Fax Number : 402-391-8979
Authorized Official
Title or Position : PRESIDENT
Name : MR. MICHAEL KENT PERRY
Credential : C.R.N.A.
Telephone Number : 402-492-8544
Provider Enumeration Date : 05/23/2007
Last Update Date : 04/19/2012

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Directions to “PAIN MANAGEMENT PC ” Practice Location

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