Provider Demographics
NPI:1093865537
Name:INFECTIOUS DISEASE ASSOCIATES PC
Entity Type:Organization
Organization Name:INFECTIOUS DISEASE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:L
Authorized Official - Last Name:PFEIFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:402-354-8155
Mailing Address - Street 1:8111 DODGE ST
Mailing Address - Street 2:SUITE 363
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4129
Mailing Address - Country:US
Mailing Address - Phone:402-354-8155
Mailing Address - Fax:
Practice Address - Street 1:933 E PIERCE ST
Practice Address - Street 2:
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-4626
Practice Address - Country:US
Practice Address - Phone:712-396-6000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0717280Medicaid
NE07614OtherBCBS
NE07614OtherBCBS
CS2247Medicare ID - Type UnspecifiedRR MEDICARE
NE=========13Medicaid
IA0717280Medicaid