MEDICARE: OSIE, 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	332B00000X	Durable Medical Equipment & Medical Supplies
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy
4	3336C0004X	Compounding Pharmacy
5	3336H0001X	Home Infusion Therapy Pharmacy
6	3336L0003X	Long Term Care Pharmacy	2590	NE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2154913	OTHER		PK

General Provider Information

NPI Number	:	1871966184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSIE, INC.

Provider Business Mailing Address
First Line	:	1221 N COTNER BLVD
Second Line	:	STE 1
City	:	LINCOLN
State	:	NE
Zip	:	68505-1879
Country	:	US
Telephone Number	:	402-466-7283
Fax Number	:	402-466-5387

Provider Business Practice Location Address
First Line	:	1221 N COTNER BLVD STE 1
Second Line	:
City	:	LINCOLN
State	:	NE
Zip	:	68505-1879
Country	:	US
Telephone Number	:	402-466-7283
Fax Number	:	402-466-5387

Authorized Official
Title or Position	:	PRESIDENT
Name	:	STEVAN OSENBAUGH
Credential	:
Telephone Number	:	402-466-7283

Provider Enumeration Date	:	11/09/2015
Last Update Date	:	11/09/2015

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Directions to “OSIE, INC. ” Practice Location

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