| Omaha Medical Group Llc | |
|
9015 Arbor St Ste 144 Omaha NE 68124-2072 | |
| (402) 588-0678 | |
| (402) 588-0678 |
| Full Name | Omaha Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9015 Arbor St Ste 144, Omaha, Nebraska |
| Authorized Official Name and Position | Jacqueline O Chanlatte-garcia (PRESIDENT) |
| Authorized Official Contact | 4025880678 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Omaha Medical Group Llc 9015 Arbor St Ste 144 Omaha NE 68124-2072 Ph: (402) 588-0678 | Omaha Medical Group Llc 9015 Arbor St Ste 144 Omaha NE 68124-2072 Ph: (402) 588-0678 |
| NPI Number | 1922438829 |
|---|---|
| Provider Enumeration Date | 11/14/2013 |
| Last Update Date | 09/14/2021 |
| Medicare PECOS PAC ID | 0648400358 |
|---|---|
| Medicare Enrollment ID | O20140225001270 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922438829 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jacqueline O Chanlatte-garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801819537 PECOS PAC ID: 0042231649 Enrollment ID: I20051212000122 |
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