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106 S 3rd St Cedar Rapids NE 68627 | |
(308) 358-0615 | |
(308) 358-0617 |
Full Name | |
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Speciality | Clinic/Center |
Location | 106 S 3rd St, Cedar Rapids, Nebraska |
Authorized Official Name and Position | Lisa Lynne Kennedy (OFFICE MANAGER) |
Authorized Official Contact | 4026782232 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 313 Cedar Rapids NE 68627-0313 Ph: (308) 358-0615 | 106 S 3rd St Cedar Rapids NE 68627 Ph: (308) 358-0615 |
NPI Number | 1932287570 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 10/24/2023 |
Medicare PECOS PAC ID | 3870575806 |
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Medicare Enrollment ID | O20061031000184 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932287570 | NPI | - | NPPES |
10025570600 | Medicaid | NE | |
10025570700 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |