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1621 Front St Henderson NE 68371-8902 | |
(402) 723-4512 | |
(402) 723-4520 |
Full Name | |
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Speciality | Family Medicine |
Location | 1621 Front St, Henderson, Nebraska |
Authorized Official Name and Position | Jill Ann Myers (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 4027234512 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1621 Front St Henderson NE 68371-8902 Ph: (402) 723-4512 | 1621 Front St Henderson NE 68371-8902 Ph: (402) 723-4512 |
NPI Number | 1710990577 |
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Provider Enumeration Date | 08/14/2006 |
Last Update Date | 09/23/2020 |
Medicare PECOS PAC ID | 4284605700 |
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Medicare Enrollment ID | O20040805001205 |
Identifier | Type | State | Issuer |
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1710990577 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |