Provider Demographics
NPI:1093802159
Name:THE AMBASSADOR PHYSICIANS CENTER INC
Entity Type:Organization
Organization Name:THE AMBASSADOR PHYSICIANS CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:JUILFS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-873-7791
Mailing Address - Street 1:1901 1ST AVE
Mailing Address - Street 2:P O BOX 640
Mailing Address - City:NEBRASKA CITY
Mailing Address - State:NE
Mailing Address - Zip Code:68410-2140
Mailing Address - Country:US
Mailing Address - Phone:402-873-7791
Mailing Address - Fax:402-873-7244
Practice Address - Street 1:4405 NORMAL BLVD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-5551
Practice Address - Country:US
Practice Address - Phone:402-488-2355
Practice Address - Fax:402-488-2779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty