Pivot Concierge Health, Llc | |
2801 S 88th St Omaha NE 68124-3056 | |
(402) 885-8125 | |
(402) 625-0578 |
Full Name | Pivot Concierge Health, Llc |
---|---|
Speciality | Family Medicine |
Location | 2801 S 88th St, Omaha, Nebraska |
Authorized Official Name and Position | Anthony Buda (OWNER) |
Authorized Official Contact | 4023501024 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Pivot Concierge Health, Llc 2801 S 88th St Omaha NE 68124-3056 Ph: (402) 885-8125 | Pivot Concierge Health, Llc 2801 S 88th St Omaha NE 68124-3056 Ph: (402) 885-8125 |
NPI Number | 1891251898 |
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Provider Enumeration Date | 02/14/2019 |
Last Update Date | 02/18/2020 |
Medicare PECOS PAC ID | 0143659144 |
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Medicare Enrollment ID | O20200326000572 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891251898 | NPI | - | NPPES |
10026770100 | Medicaid | NE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Laura L Anderson |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1962516450 PECOS PAC ID: 1951306620 Enrollment ID: I20061002000492 |
Provider Name | David William Bouda |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1912021635 PECOS PAC ID: 5799876710 Enrollment ID: I20200326000806 |
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