| Mobile Health Center Pc | |
|
4737 South 96th St 100 Omaha NE 68127 | |
| (402) 339-3187 | |
| Not Available |
| Full Name | Mobile Health Center Pc |
|---|---|
| Speciality | Dentist |
| Location | 4737 South 96th St, Omaha, Nebraska |
| Authorized Official Name and Position | Shandra Wilkins (DIRECTOR) |
| Authorized Official Contact | 4024443221 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Health Center Pc 4102 Woolworth Ave Suite 100 Omaha NE 68105-1851 Ph: (402) 444-3221 | Mobile Health Center Pc 4737 South 96th St 100 Omaha NE 68127 Ph: (402) 339-3187 |
| NPI Number | 1427288042 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 08/09/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427288042 | NPI | - | NPPES |
| 10025450000 | Medicaid | NE | |
| 10025882700 | Medicaid | NE | |
| 10025902200 | Medicaid | NE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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