Provider Demographics
NPI:1114919875
Name:THE UROLOGY CENTER, PC
Entity Type:Organization
Organization Name:THE UROLOGY CENTER, PC
Other - Org Name:UROLOGY CENTER PC
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FOREHEAD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-397-9800
Mailing Address - Street 1:111 S 90TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-3907
Mailing Address - Country:US
Mailing Address - Phone:402-397-9800
Mailing Address - Fax:402-397-7591
Practice Address - Street 1:111 S 90TH ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-3907
Practice Address - Country:US
Practice Address - Phone:402-397-9800
Practice Address - Fax:402-397-7591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2023-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty