| Miracle Hills Primary Care Center Pc | |
|
11819 Miracle Hills Dr Ste 105 Omaha NE 68154-4428 | |
| (402) 905-2075 | |
| (402) 905-9864 |
| Full Name | Miracle Hills Primary Care Center Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 11819 Miracle Hills Dr Ste 105, Omaha, Nebraska |
| Authorized Official Name and Position | Maman L Ali (PRESIDENT) |
| Authorized Official Contact | 4029052075 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Miracle Hills Primary Care Center Pc 11819 Miracle Hills Dr Ste 105 Omaha NE 68154-4428 Ph: (402) 905-2075 | Miracle Hills Primary Care Center Pc 11819 Miracle Hills Dr Ste 105 Omaha NE 68154-4428 Ph: (402) 905-2075 |
| NPI Number | 1104292093 |
|---|---|
| Provider Enumeration Date | 08/14/2015 |
| Last Update Date | 08/14/2015 |
| Medicare PECOS PAC ID | 4183933302 |
|---|---|
| Medicare Enrollment ID | O20151028002357 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104292093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Kelly Jodel Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669887584 PECOS PAC ID: 1254550296 Enrollment ID: I20150730011186 |
Eagle Run Chiropractic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13808 W Maple Rd, Suite 116, Omaha, NE 68164 Phone: 402-491-4087 Fax: 402-491-4091 | |
Bott Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11810 Nicholas St Ste 101, Omaha, NE 68154 Phone: 402-779-8400 Fax: 402-779-8401 | |
Sanchez Family Medical Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3440 S 50th St, Omaha, NE 68106 Phone: 402-214-9040 Fax: 402-884-0088 | |
Powers Chiropractic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11343 Wright Cir, Omaha, NE 68144 Phone: 402-504-4344 Fax: 402-504-1173 | |
Physicians Of Internal Medicine, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7710 Mercy Rd Ste 601, Omaha, NE 68124 Phone: 402-397-5236 Fax: 402-397-8864 | |
Trillion Health And Hormone Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12002 Pacific St, Omaha, NE 68154 Phone: 402-201-2373 Fax: 402-201-2432 | |
Jayanthi Ganesan, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4242 Farnam St, #142, Omaha, NE 68131 Phone: 402-552-2212 Fax: 402-552-2263 |