Provider Demographics
NPI:1033229364
Name:NEBRASKA PULMONARY ASSOCIATES PC
Entity Type:Organization
Organization Name:NEBRASKA PULMONARY ASSOCIATES PC
Other - Org Name:PULMONARY MEDICINE ASSOCIATES OF NEBRASKA PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:M.D./PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LON
Authorized Official - Middle Name:W
Authorized Official - Last Name:KEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-552-9700
Mailing Address - Street 1:4242 FARNAM ST
Mailing Address - Street 2:#355
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68131-2806
Mailing Address - Country:US
Mailing Address - Phone:402-552-9700
Mailing Address - Fax:402-552-9710
Practice Address - Street 1:4242 FARNAM ST
Practice Address - Street 2:#355
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68131-2806
Practice Address - Country:US
Practice Address - Phone:402-552-9700
Practice Address - Fax:402-552-9710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEDE6675OtherRAILROAD MEDICARE
NE10025359300Medicaid
NE099804Medicare ID - Type Unspecified
IAI17071Medicare ID - Type Unspecified
NEDE6675OtherRAILROAD MEDICARE