City Of Genoa | |
505 S Park St Genoa NE 68640-3036 | |
(402) 993-2206 | |
(402) 993-2595 |
Full Name | City Of Genoa |
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Speciality | Clinic/Center |
Location | 505 S Park St, Genoa, Nebraska |
Authorized Official Name and Position | Amanda Roebuck (CEO) |
Authorized Official Contact | 4029934583 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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City Of Genoa 505 S Park St Po Box 310 Genoa NE 68640-3036 Ph: (402) 993-2206 | City Of Genoa 505 S Park St Genoa NE 68640-3036 Ph: (402) 993-2206 |
NPI Number | 1104859206 |
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Provider Enumeration Date | 07/09/2006 |
Last Update Date | 01/23/2020 |
Medicare PECOS PAC ID | 5193702777 |
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Medicare Enrollment ID | O20040901001124 |
Identifier | Type | State | Issuer |
---|---|---|---|
1104859206 | NPI | - | NPPES |
NA RH | Medicaid | NE | |
10025924300 NRH | Medicaid | NE | |
273722254 | Other | NE | COMMERCIAL |
273722254 | Other | NE | BLUE CROSS BLUE SHIELD |
CS4410 | Other | NE | RAILROAD MEDICARE |
NA | Other | NE | CHAMPUS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Provider Name | Terry L Troyer |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1326031212 PECOS PAC ID: 2365418787 Enrollment ID: I20040908000268 |
Provider Name | Brian K Buhlke |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1598870255 PECOS PAC ID: 5890696785 Enrollment ID: I20041209000864 |
Provider Name | Vicki D Peterson Truksa |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1053671883 PECOS PAC ID: 4688822158 Enrollment ID: I20120907000559 |
Provider Name | Stacy K Nelson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386994325 PECOS PAC ID: 7416109350 Enrollment ID: I20121128000740 |
Provider Name | Molly M Oertwig |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215304704 PECOS PAC ID: 3971803826 Enrollment ID: I20151124002541 |
Provider Name | Jordan S Brester |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1710548292 PECOS PAC ID: 3173858065 Enrollment ID: I20190715002988 |
Provider Name | Kimberly R Brandenburg |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1740842640 PECOS PAC ID: 0042546723 Enrollment ID: I20190802000250 |
Provider Name | Stacy Grabowski |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1215586235 PECOS PAC ID: 1153714837 Enrollment ID: I20220201000804 |
Provider Name | Lauren J Esch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1578172045 PECOS PAC ID: 6901299346 Enrollment ID: I20220208002447 |
Park Street Medical Clinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 505 S Park St, Genoa, NE 68640 Phone: 402-993-2205 Fax: 402-993-2595 | |
Park Street Medical Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 505 South Park Street, Genoa, NE 68640 Phone: 402-993-2206 Fax: 402-993-2595 |