MEDICARE: ERIC GLENN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	171W00000X	Contractor
2	251E00000X	Home Health Agency
3	253Z00000X	In Home Supportive Care Agency
4	332U00000X	Home Delivered Meals
5	372500000X	Chore Provider
6	376J00000X	Homemaker
7	385H00000X	Respite Care
8	385HR2055X	Child Mental Illness Respite Care
9	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care
10	385HR2065X	Child Physical Disabilities Respite Care
11	372600000X	Adult Companion

General Provider Information

NPI Number	:	1679425854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC GLENN

Provider Business Mailing Address
First Line	:	8611 BLONDO ST STE 3
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-6159
Country	:	US
Telephone Number	:	531-203-7227
Fax Number	:

Provider Business Practice Location Address
First Line	:	8611 BLONDO ST STE 3
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68134-6159
Country	:	US
Telephone Number	:	531-203-7227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2026
Last Update Date	:	02/11/2026

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Directions to “ ERIC GLENN ” Practice Location

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