MEDICARE: HUNTING ISLE, INC

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
1	251E00000X	Home Health Agency	HHA1036	NE

General Provider Information

NPI Number	:	1457773954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNTING ISLE, INC

Provider Business Mailing Address
First Line	:	5437 N 103RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-1002
Country	:	US
Telephone Number	:	402-991-9880
Fax Number	:	402-991-9889

Provider Business Practice Location Address
First Line	:	5437 N 103RD ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-1002
Country	:	US
Telephone Number	:	402-991-9880
Fax Number	:	402-991-9889

Authorized Official
Title or Position	:	OWNER
Name	:	DENISE MAGILL
Credential	:
Telephone Number	:	402-991-9880

Provider Enumeration Date	:	01/17/2014
Last Update Date	:	01/17/2014

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Directions to “HUNTING ISLE, INC ” Practice Location

Language	Start Address	Practice Location

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