Ivy Street Medical Llc | |
902 Ivy St Stanton NE 68779-2348 | |
(402) 439-5500 | |
(402) 439-5502 |
Full Name | Ivy Street Medical Llc |
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Speciality | Clinic/center - Rural Health |
Location | 902 Ivy St, Stanton, Nebraska |
Authorized Official Name and Position | Karla E Damgaard (OWNER) |
Authorized Official Contact | 4024395500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Ivy Street Medical Llc Po Box 47 Stanton NE 68779-0047 Ph: (402) 439-5500 | Ivy Street Medical Llc 902 Ivy St Stanton NE 68779-2348 Ph: (402) 439-5500 |
NPI Number | 1487806147 |
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Provider Enumeration Date | 10/14/2008 |
Last Update Date | 10/14/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487806147 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |