Provider Demographics
NPI:1073749172
Name:OMAHA HEART HOSPITAL LLC
Entity Type:Organization
Organization Name:OMAHA HEART HOSPITAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCLEAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:402-991-7166
Mailing Address - Street 1:8552 CASS ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3570
Mailing Address - Country:US
Mailing Address - Phone:402-991-5300
Mailing Address - Fax:402-991-5407
Practice Address - Street 1:8552 CASS ST
Practice Address - Street 2:SUITE 250
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3570
Practice Address - Country:US
Practice Address - Phone:401-991-7166
Practice Address - Fax:402-991-5407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital