MEDICARE: CAREAGE MANAGEMENT, LLC

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	314000000X	Skilled Nursing Facility	324003	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	212658208	OTHER	NE	STATE ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0283	OTHER	NE	BLUE CROSS BLUE SHIELD
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1750384384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CAREAGE MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	1800 IRVING ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310
Country	:	US
Telephone Number	:	402-223-2311
Fax Number	:	402-228-1601

Provider Business Practice Location Address
First Line	:	1800 IRVING ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310
Country	:	US
Telephone Number	:	402-223-2311
Fax Number	:	402-228-1601

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. DANIEL T MYERS
Credential	:
Telephone Number	:	712-293-0117

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	05/20/2009

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