Provider Demographics
NPI:1003409871
Name:SANCHEZ FAMILY MEDICAL LLC
Entity Type:Organization
Organization Name:SANCHEZ FAMILY MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD AND OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RODOLFO
Authorized Official - Middle Name:M
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD AND OWNER
Authorized Official - Phone:402-216-6020
Mailing Address - Street 1:3440 S 50TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-3829
Mailing Address - Country:US
Mailing Address - Phone:402-216-6020
Mailing Address - Fax:402-884-0088
Practice Address - Street 1:3440 S 50TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68106-3829
Practice Address - Country:US
Practice Address - Phone:402-214-9040
Practice Address - Fax:402-884-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-12
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE21472OtherNE LISCENCE