Provider Demographics
NPI:1073382784
Name:NEW HORIZONS O & P EFFINGHAM LLC
Entity Type:Organization
Organization Name:NEW HORIZONS O & P EFFINGHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:308-698-0500
Mailing Address - Street 1:8 W 56TH ST STE 3B
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-0500
Mailing Address - Country:US
Mailing Address - Phone:308-698-0500
Mailing Address - Fax:308-698-0502
Practice Address - Street 1:606 S 4TH ST
Practice Address - Street 2:
Practice Address - City:EFFINGHAM
Practice Address - State:IL
Practice Address - Zip Code:62401-3712
Practice Address - Country:US
Practice Address - Phone:308-698-0500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW HORIZONS ORTHOTICS & PROSTHETICS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-12-21
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier